RESUMO
PURPOSE: To examine interdisciplinary collaboration via electronic medical records (EMRs) with a focus on physicians' perception of nursing documentation. DESIGN: Quality improvement project using a survey instrument. LOCATION: Tertiary care pediatric hospital. PARTICIPANTS: Thirty-seven physicians. OUTCOME MEASURE: Physicians perceptions of nursing documentation after EMR implementation KEY FINDINGS: Physicians desire nursing documentation with greater clarity and additional information. Physicians indicate checklists alone for patient assessment and intervention data are insufficient for effective nurse/physician collaboration. Narrative nursing summaries are invaluable references that guide medical treatment decisions. Physicians see detailed assessments and well-described interventions of nurses' as critical to their ability to effectively practice medicine. KEY CONCLUSIONS: Health care technology is called to develop EMRs that enable nurses to document detailed patient data in a swift and straightforward manner. Joint collaboration between nurses, physicians, and technology specialists is recommended to develop effective EMR systems.