Nurses are the only frontline professionals of the healthcare team that spend maximum time at the patient bedside. As a part of the nursing process, nurses generate and record pertinent patient information which primarily forms the basis for the decisions made by the healthcare team. Continued commitment to maintaining nursing excellence and quality nursing documentation remains crucial. Quality nursing documentation isa prerequisite for a safe and effective nursing care. Substandard nursing documentation poses risk to evaluation and outcomes of patient care. Despite so much attentionbeingfocused on quality nursing documentation, deficiencies in nursing documentation however, continue to exist. In order to resolve these insufficiencies, it is paramount to identify, develop and operationalize strategies to improve quality of nursing documentation. Electronic health records are being promoted as a strategy for exchange of pertinent patient information among members of the health care team while protecting patients’ privacy and improving the safety, efficacy and quality of care. It is believed that technology will help improve clinical decision-making ability, ensure better quality of patient care and contain healthcare cost. However, operationalizing a change in practice in healthcare environment has the tendency to create unease among nurses with the risk of making them defiant to the change. The main aim of the study was to evaluate the effectiveness of electronic nursing documentation programme in terms of quality of nursing documentation and nurses’ perception. It was also planned to ascertain nurses’ acceptability and utility of the electronic nursing documentation programme. The objectives of the study were to: assess and compare the quality of paper based and electronic nursing documentation; explore the perception of nurses regarding electronic nursing documentation before and after the implementation of electronic nursing documentation programme; ascertain opinion of nurses regardingacceptability and utility of electronic nursing documentation programme; determine the relationship between perception and acceptability and utility of nurses exposed to electronic nursing documentation programme. This quasi-experimental study with one group pretest posttest design was conducted in a tertiary teaching hospital of Haryana. The sample included; 152 randomly selected paper-based nursing records, 644 electronic nursing records selected by total enumeration and 44 nurses working in selected units using total enumeration sampling technique. In phase I, 152 randomly selected paper-based nursing records were reviewed to examine the quality of paper based nursing documentation from day 1 to day 75. In the phase II, day 1 was assigned to assessment of nurses’ perception regarding electronic nursing documentation. Day 2 to day 5 were dedicated to; sensitization of nurses regarding basic computer functions; electronic nursing documentation and hands on practice by nurses to familiarize themselves with computers. The implementation of the END programme comprised of 19 days of training programme for the nurses from day 6 to day 24. Nurses received training on the five modules of electronic nursing documentation programme that includeddemonstration of electronic documentation of the module by the investigator and hand on practice by the nurses till at least one correct return demonstration. Modules I (patient profile) and II (health assessment) were introduced from day 6 to 8 and day 9 to 11 respectively. Modules III (vital signs) and IV (intake output) were introduced together from day 12 to 14. module V (medication administration and need based care)was introduced from day 15 to 17. Day 18 to day 24 were dedicated to handholding that included; open discussions with nurses, obtaining feedback, clarification of doubts, reinforcement and practice of all the five modules of electronic nursing documentation programme together. On day 100 of phase II, nurses’ perception and acceptability and utility of END programme was assessed. Data was analyzed using SPPS 20.2. The level of significance was kept at 0.05. Findings revealed that END programme was effective in improving the overall quality of nursing documentation in terms of patient profile, admission, intake, output, medication administration and need based care and nurses’ perception regarding electronic nursing documentation. However, no improvement was seen in quality of electronic nursing documentation in terms of vital signs. In addition, nurses expressed END programme to be highly acceptable and useful. Low positive but non- significant relationship was established between the nurses’ perception and acceptability and utility of END programme. Further studies can be undertaken to; identify and develop strategies for best practices and standards for improved, streamlined nursing documentation; explore the factors that contribute to poor nursing documentation; include nursing process, nursing care plan in electronic nursing documentation; examine the various types of hardware and supporting equipment used in electronic documentation, such as computers on wheels and handheld devices and how different types of equipment enhance compliance with use and accessibility; compare the quality of nursing documentation and nurses’ perception in private and public sector.
