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J Nurs Scholarsh. 2011 Jun;43(2):154-62. doi: 10.1111/j.1547-5069.2011.01397.x. Epub 2011 Apr 11.

Electronic nursing documentation as a strategy to improve quality of patient care.

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Gamma Epsilon, Duke University School of Nursing, Durham, NC.



Electronic health records are expected to improve the quality of care provided to hospitalized patients. For nurses, use of electronic documentation sources becomes highly relevant because this is where they obtain the majority of necessary patient information.


An integrative review of the literature examined the relationship between electronic nursing documentation and the quality of care provided to hospitalized patients. Donabedian's quality framework was used to organize empirical literature for review.


To date, the use of electronic nursing documentation to improve patient outcomes remains unclear.


Future research should investigate the day-to-day interactions between nurses and electronic nursing documentation for the provision of quality care to hospitalized patients.


The majority of U.S. hospital care units currently use paper-based nursing documentation to exchange patient information for quality care. However, by 2014, all U.S. hospitals are expected to use electronic nursing documentation on patient care units, with the anticipated benefit of improved quality. However, the extent to which electronic nursing documentation improves the quality of care to hospitalized patients remains unknown, in part due to the lack of effective comparisons with paper-based nursing documentation.

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