Nursing documentation and its relationship with perceived nursing workload: a mixed-methods study among community...

Area of Science:

• Nursing Practice
• Health Services Research
• Healthcare Informatics

Background:

• Nursing documentation is time-consuming and burdensome.
• The relationship between documentation activities and perceived nurse workload is not well understood.
• Distinguishing between clinical and organizational documentation is crucial for workload analysis.

Purpose of the Study:

• To investigate community nurses' perceptions of the link between clinical and organizational documentation and their workload.
• To differentiate the impact of clinical versus organizational documentation on perceived nursing workload.

Main Methods:

• Convergent mixed-methods design utilizing quantitative surveys (n=195) and qualitative focus groups (n=28).
• Quantitative analysis included descriptive statistics, Wilcoxon tests, and Spearman correlations.
• Qualitative analysis employed thematic analysis through an iterative data collection and analysis process.

Main Results:

• Most community nurses reported high workloads from documentation, with perceived workload being comparable for clinical and organizational tasks despite differing time allocations.
• Organizational documentation was perceived as redundant, and actual time spent on it correlated with perceived workload, unlike clinical documentation.
• No association was found between perceived workload and electronic health record user-friendliness or centrality of the nursing process, though qualitative data highlighted user-friendliness impacts.

Conclusions:

• Community nurses face significant workload challenges from both clinical and organizational documentation.
• Reducing time spent on organizational documentation and improving electronic health record user-friendliness and intercommunicability are vital for mitigating perceived nursing workload.