Reducing documentation burden to improve nurse and midwife satisfaction: A mixed-methods study

To examine midwife and nurse satisfaction pre- and post- an intervention designed to decrease documentation burden in a maternity setting.

The burden imposed on nurses and midwives by documentation demands are a source of dissatisfaction, resulting in missed care, worsening job dissatisfaction.

A convergent mixed-methods design (QUAN + Qual). Satisfaction was examined using a survey to collect quantitative data and focus groups to collect qualitative data. The intervention reviewed documentation for duplication, redundancy, and modification, resulting in the creation of streamlined, and user-friendly documentation. Data were collected using a validated tool developed to measure nursing and midwifery documentation burden, and via focus groups to explore satisfaction pre- and post-intervention and changes to documentation.

Following integration of the data, feedback from the focus groups (n = 17) confirmed the survey results from n = 28 post-intervention respondents; participants were satisfied with many elements of the new documentation. The focus groups also highlighted areas where further refinements to the new documentation could be made. The intervention improved midwives' satisfaction with documentation with respect to ease, complexity, and relevance of the documentation. Issues with the time needed to complete documentation following the intervention remain.

Satisfaction with many elements of documentation was achieved, indicating that the focus on removing known sources of dissatisfaction with documentation, including duplication and unnecessary documentation, was effective in a maternity setting. Intervening to reduce duplication and redundancy, and modifying patient clinical documentation, can improve nurse and midwife satisfaction with this aspect of their job.

This article follows the Good Reporting of a Mixed Methods Study (GRAMMS) guidelines.¹ NO PATIENT OR PUBLIC CONTRIBUTION: What is already known about documentation burden What this paper adds.