Utilization of reinforcement contracts to increase written evidence of the nursing assessment

This study investigated if nursing personnel would increase written evidence of the nursing process if favorable consequences were arranged. The charting of 23 nurses was observed and tabulated for a three-week period. These base-line data were averaged and shared with each nurse, at which time each nurse set a goal (relative to increased charting) and chose a reward contingent upon achieving that goal. During the next three weeks the nurses were again observed, at the end of which results were tabulated and rewards given. The two periods were repeated. Results showed a sharp increase in charting during each reinforcement phase and a fall off during the second base-line period that was lower than the first base-line. The target behavior, therefore, was found to be increased by systematic reinforcement.