Increasing Nursing Documentation Efficiency With Wearable Sensors for Pressure Injury Prevention.

ABSTRACT

BACKGROUND: Documentation presents an overwhelming burden to bedside clinical nurses. Nurses must manually enter several hundred data points into electronic health record flow sheets, taking time from direct patient care and introducing opportunity for documentation errors. LOCAL PROBLEM: A patient record audit revealed a significant gap in documented patient repositioning events. This quality improvement initiative evaluated automated repositioning documentation via a wearable sensor system. METHODS: A pretest-posttest design was used to examine retrospectively collected manual documentation and prospectively collected sensor documentation of patient repositioning events in a 148-bed rural community hospital. Repositioning documentation manually entered into electronic health records during the baseline period (January 1 to February 28, 2018) was compared with automatic, sensor-based repositioning documentation during the implementation period (corresponding months in 2019 and 2020 to eliminate seasonality). RESULTS: A convenience sample of 105 patient records was reviewed. The mean documented patient repositioning interval was 6.6 hours in the baseline period and 2.4 hours in the implementation period. The improvement was most pronounced in patients with obesity, whose mean repositioning interval improved from 9.4 hours to 2.5 hours. Documentation compliance (actual vs expected repositioning documentation) was 31% with manual documentation and 82% with automatic sensor-based documentation. CONCLUSIONS: Repositioning was documented more than 2.5 times as frequently with sensor technology as with manual data entry. Body position and reasons for delayed repositioning events were documented more completely with sensor technology. Automated documentation may improve the accuracy of electronic health records and reduce the documentation burden for nurses.