Evaluation of the impact of a bedside terminal system in a rapidly changing community hospital

The impact of a bedside terminal system implemented in a community hospital was evaluated using a one-group before-and-after design. Contrary to predictions, the amount of time registered nurses spent in direct care and the positiveness of registered nurses' attitudes toward bedside terminal technology decreased after the implementation. Registered nurse overtime decreased in accordance with the prediction and unit medication errors remained unchanged. The internal validity of these results was threatened by organizational changes that directly and indirectly affected the study unit. Recommendations are made for conducting evaluation research in a rapidly changing hospital environment.