Aims and objectives. To examine the effect of the introduction of an electronic nursing documentation system on the efficiency
of documentation in a residential aged care facility.
Background. Modern technology has the potential to free caregivers in residential aged care facilities from their burden of paper
documentation and allow them more time to care for residents. To date, there is inadequate evidence to verify this assumption.
Design. Longitudinal cohort study with work sampling method for data collection.
Methods. This study was conducted between 2009–2011; two months before and 3, 6, 12 and 23 months after implementation
of an electronic documentation system. A work classification tool was used by an observer to record documentation activities
being performed on paper or on a computer by the caregivers.
Results. When compared with the proportion of time caregivers spent on documentation in the preimplementation period,
personal carers’ proportion reduced at three months after implementation. The proportion increased from six months and then
dropped at 23 months. Recreational activity officers’ proportion increased at three months after implementation. It stabilised at
six months and increased again at 12 months. At 23 months, the proportion returned to the preimplementation level. Less than
half of the caregivers’ time on documentation after implementation was associated with computer-related tasks.
Conclusions. Introduction of an electronic documentation system may not necessarily lead to efficiency in documentation for
the caregivers. Charting some information items on paper and others on a computer may hinder realization of documentation
Relevance to clinical practice. To optimise the efficiency benefit of electronic documentation in a residential aged care facility, it
is not only necessary to automate all nursing forms but also to ensure that the system is aligned with caregivers’ documentation
practice. Continuous education and mentor support is essential to ensure caregivers’ effective usage of the electronic system.