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    READS: the rapid electronic assessment documentation system.

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    Authors
    Hickey, Ann
    Gleeson, Margaret
    Kellett, John
    Affiliation
    Nenagh Hospital, Nenagh, Ireland.
    Issue Date
    2012-12-13
    MeSH
    Documentation
    Electronic Health Records
    Hospitals, General
    Hospitals, Rural
    Humans
    Ireland
    Nursing Records
    Nursing Staff, Hospital
    Workload
    
    Metadata
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    Citation
    READS: the rapid electronic assessment documentation system., 21 (22):1333-6, 1338-40 Br J Nurs
    Journal
    British journal of nursing (Mark Allen Publishing)
    URI
    http://hdl.handle.net/10147/270353
    PubMed ID
    23249801
    Abstract
    Patient documentation is time consuming and can detract from care. The authors report a novel computer programme that manipulates routinely collected information to quantify nursing workload, along with the reason for admission, functional status, estimates of in-hospital mortality and life expectancy. The programme stores information in a database, and produces a print-out in a situation/background/assessment/recommendation (SBAR) format. The average time taken to enter 629 patient encounters was 6.6 minutes. Pain was the most common presentation for low workload patients, while high workload patients often presented with altered mental status and reduced mobility. There was only a modest correlation between the risk of death and nursing workload. The programme measures nursing workload without further paperwork, and improves routine documentation with a legible brief report that is automatically generated. This report can be shared and provides data that is immediately available for day-to-day care, audit, quality control and service planning.
    Item Type
    Article
    Language
    en
    ISSN
    0966-0461
    Collections
    Nenagh General Hospital

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