Preparing Today's Nursing Students for Tomorrow's Career

Integrating an Innovative, Cost-Effective Electronic Documentation System for Undergraduate Nursing Students

Over the past 15 years, the use of electronic medical record systems in the healthcare setting has grown exponentially. Accurate input of patient data is critical to facilitate safe care and effective communication among all members of the healthcare team. To keep pace with the practice environment, nursing students must have the opportunity to document health-related information in an electronic medical record early in the educational program. The purpose of this project was to create a cost-effective electronic medical record system for undergraduate nursing students to learn appropriate documentation of patient-related findings. Patient-centered care, informatics, and safety were the focus topics from the Quality and Safety Education for Nurses project included in the development of this endeavor. Faculty worked in collaboration with the university's information technology department to develop an innovative electronic medical record to be used in physical assessment, which is the first course in the nursing curriculum. Positive feedback was obtained from students and faculty about the project. It is important to provide students with the opportunity to experience electronic documentation to effectively prepare them for the ever-changing practice environment.

Academic Electronic Health Records in Undergraduate Nursing Education: Mixed Methods Pilot Study

BACKGROUND

Teaching students about electronic health records presents challenges for most nursing programs, primarily because of the limited training opportunities within clinical practice settings. A simulated electronic health record is an experiential, learner-centered strategy that enables students to acquire and apply the informatics knowledge needed for working with electronic records in a safe learning environment before the students have encounters with real patients.

OBJECTIVE

The aim of this study is to provide a preliminary evaluation of the Lippincott DocuCare simulated electronic health record and determine the feasibility issues associated with its implementation.

METHODS

We used one-group pretest-posttest, surveys, and focus group interviews with students and instructors to pilot the DocuCare simulated electronic health record within an undergraduate nursing program in Western Canada. Volunteering students worked through 4 case scenarios during a 1-month pilot. Self-reported informatics knowledge and attitudes toward the electronic health record, accuracy of computerized documentation, satisfaction, and students' and educators' experiences were examined. Demographic and general information regarding informatics learning was also collected.

RESULTS

Although 23 students participated in this study, only 13 completed surveys were included in the analysis. Almost two-thirds of the students indicated their overall understanding of nursing informatics as being fair or inadequate. The two-tailed paired samples t test used to evaluate the impact of DocuCare on students' self-reported informatics knowledge and attitudes toward the electronic health record revealed a statistically significant difference in the mean score of knowledge before and after using DocuCare (before: mean 2.95, SD 0.58; after: mean 3.83, SD 0.39; t 12=5.80, two-tailed; P<.001). There was no statistically significant difference in the mean scores of attitudes toward the electronic health record before and after using DocuCare (before: mean 3.75, SD 0.40; after: mean 3.70, SD 0.34; t 12=0.39, two-tailed; P=.70). Students' documentation scores varied from somewhat accurate to completely accurate; however, performance improved for the majority of students as they progressed from case scenarios 1 to 4. Both the faculty and students were highly satisfied with DocuCare and highly recommended its integration. Focus groups with 7 students and 3 educators revealed multiple themes. The participants shared suggestions regarding the DocuCare product customization and strategies for potential integration in undergraduate nursing programs.

CONCLUSIONS

This study demonstrated the feasibility and suitability of the DocuCare program as a tool to enhance students' learning about informatics and computerized documentation in electronic health records. Recommendations will be made to academic leadership in undergraduate programs on the basis of this study. Furthermore, a controlled evaluation study will be conducted in the future.