A study on the development of nursing information systems to improve the quality of nursing practice

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The purpose of this study is to identify the key features of electronic nursing records (ENRs) to improve the quality of nursing practice. When early ENR systems replaced paper forms, their many screens often interfered with the thinking process of nurses. We interviewed 31 nurses at 16 hospitals and recorded videos when they used ENR systems before their shift. The information the nurses needed depended on the nurses' knowledge and experience. Less experienced nurses needed only orders, the patients' chief complaint, whereas experienced nurses required justification of orders, estimation of patient's prognosis, and management issues. The design of ENR systems should comply with the thinking process of nurses that this research has identified.