Resuscitation Documentation: Mobility and Efficiency through Tablet-Based Solutions
Accurate recording of medical resuscitations is crucial for subsequent patient care. However, the intense nature of these situations requires the full attention of the medical staff, often resulting in incomplete documentation. Could a tablet-based application improve the quality of these records?
Implementation and Usage of Electronic Health Records (EHR)
The healthcare industry is becoming increasingly interconnected. One part of this digitalization process is the growing use of electronic health records (EHR). EHR contain patient data, including personal information such as name, age, and insurance details, as well as medical information such as diagnoses (1). EHR implementation offers several advantages, including reducing medical errors, improving communication among healthcare professionals, and enhancing the coordination of patient care (2). Another important aspect of EHR is the increased accessibility of health information for patients themselves (3). Despite these potential benefits, implementing EHR presents several challenges, including technical difficulties, such as compatibility problems with hospital systems (2). A major concern involves healthcare professionals‘ apprehensions, such as risks to patient privacy, increased administrative workload, and potential negative impacts on the physician-patient relationship (4). Meanwhile, hospitals have widely adopted basic EHR systems and start to implement advanced applications (5).
One area where standardized electronic documentation could significantly enhance the quality of care is during resuscitations. These critical situations are often under-recorded (6), even though, for example, in trauma care, accurate documentation is crucial for the quality of subsequent care (7).
Implementing the Tablet-based solutions for documenting Medical Resuscitation
In a recent study, Cheung & Yip quantitatively assessed whether the tablet-based app eResus could enhance medical resuscitation documentation in an accident and emergency department. In addition, they qualitatively investigated whether the app would gain acceptance among hospital staff. The study was conducted in a hospital in Hong Kong, where 3,600 medical resuscitations performed annually. The app was introduced in 2021 (8).
In the quantitative part of the study, they randomly selected 176 paper records from before the app’s introduction, 176 paper records from after its introduction, and 176 electronic records created using the app. They assessed the completeness of documentation using a Yes/No checklist across five key domains: basic information, vital signs, procedures, investigations, and medications (8).
In the qualitative part of the study, Cheung & Yip conducted ten interviews with emergency nurses in April 2021, followed by two additional interviews to confirm data saturation. These interviews focused on the nurses‘ experiences, the documentation advantages of the app, and areas for improvement (8).
Electronic Documentation with tablet based solutions leads to better Documentation Completeness
Cheung and Yip observed improved documentation completion rates across all domains (8). Interestingly, no improvement was observed in paper-based documentation before and after the app’s introduction, suggesting that the additional training provided during the app launch was not the primary factor driving the improvement in resuscitation records (8).
The qualitative results revealed that the app’s design, featuring structured prescriptions, preset data fields, and a guided documentation logic, provided nurses with a clear framework for documenting resuscitations. However, issues such as slow loading speeds and the need to navigate through multiple pages made the app feel more time-consuming and complex. Since nurses frequently multitask in their work, additional challenges, such as familiarizing themselves with the app’s user interface during its initial use, posed further difficulties (7).
Successful Implementation of electronic Documentation Solutions
The Technology Acceptance Model (TAM) suggests that the adoption of new technologies is influenced by their perceived usefulness and ease of use (9).
Considering the perspective of health professionals and their needs, new technologies have to be well integrated into their workflows (10). Mobile tablet-based solutions provide a level of mobility comparable to traditional paper-based documentation methods. This is particularly beneficial in situations where patients requiring medical resuscitation need to be transferred to other departments. These solutions enable uninterrupted documentation during the transfer process, facilitating continuity and accuracy in patient records (8).
Looking into the future, electronic documentation solutions could be integrated into the Internet of Things (IoT) to automatically record vital signs during resuscitations. This advancement would reduce the need for manual data entry, allowing nurses to dedicate more time to patient care (8).
References
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- Cheung K, Yip CS. Documentation Completeness and Nurses‘ Perceptions of a Novel Electronic App for Medical Resuscitation in the Emergency Room: Mixed Methods Approach. JMIR mHealth and uHealth 2024; 12:e46744.
- Georgia LB, Amber KW. Technology Acceptance Mode; 2021. Available from: URL: https://ua.pressbooks.pub/persuasiontheoryinaction/chapter/technology-acceptance-model/. 10. Wosny M, Strasser LM, Hastings J. The Paradoxes of Digital Tools in Hospitals: Qualitative Interview Study. Journal of medical Internet research 2024; 26:e56095.
