The implementation of an Electronic Nursing Record in a general hospital in the Netherlands: lessons to learn

This article describes the implementation of an Electronic Nursing Record (ENR) in Maasland Hospital (Orbis Medical and Healthcare group) in Sittard, the Netherlands. Through analysis of documents, structured interviews and participatory observation, a study was made of the plans prior to the introduction of the ENR, how the process proceeded, which enhancing and constraining factors influenced the process and how the nursing staff experienced the introduction of the ENR. The implementation of the system took place in 2006 and 2007. The selection and design of the system was carried out first, followed by a pilot phase. After thorough review and adjustment, the introduction of the ENR in the other wards of the hospital followed according to plan. The implementation process was carried out by several nurses in different roles (project management, project group members, key-users and teachers). The introduction of the system had two objectives: saving time by promoting efficiency and quality improvement by the introduction of standardization in documentation and the use of nursing care plans. The study indicates, however, that no time-efficiency was achieved by using the ENR so far. This had an adverse effect on the acceptance of the system by the nurses. The nurses were positive about the set-up of the implementation process, especially the contribution of the project group, the key-users on the ward and the resources which were made available (the staffing, external expertise and training).