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Identifying violence can help health professionals, managers and researchers improve care and reduce suffering in families and communities.

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Background There are many benefits of nursing professionals being able to consult electronic health records (EHRs) at the point of care. It promotes quality and patient security, communication, continuity of care, and time dedicated to records. Objective The aim of this study was to evaluate whether making EHRs available at the point of care with tablets reduces nurses’ time spent on records compared with the current system. The analysis included sociodemographic and qualitative variables, time spent per patient, and work shift. This time difference can be used for direct patient care. Methods A before-after time motion study was carried out in the internal medicine unit. There was a total of 130 observations of 2 hours to 3 hours in duration of complete patient records that were carried out at the beginning of the nurses' work shifts. We calculated the time dedicated to measuring vital signs, patient evaluation, and EHR recording. The main variable was time spent per patient. Results The average time spent per patient (total time/patients admitted) was lower with the tablet group (mean 4.22, SD 0.14 minutes) than with the control group (mean 4.66, SD 0.12 minutes); there were statistically significant differences (W=3.20, P=.001) and a low effect (d=.44) between groups. The tablet group saved an average of 0.44 (SD 0.13) minutes per patient. Similar results were obtained for the afternoon shift, which saved an average of 0.60 (SD 0.15) minutes per patient (t34=3.82, P=.01) and high effect (d=.77). However, although there was a mean difference of 0.26 (SD 0.22) minutes per patient for the night shift, this was not statistically significant (t29=1.16, P=.25). The “nonparticipating” average age was higher (49.57, SD 2.92 years) compared with the “afternoon shift participants” and “night shift participants” (P=.007). “Nonparticipants” of the night shift had a worse perception of the project. Conclusions This investigation determined that, with EHRs at the point of care, the time spent for registration by the nursing staff decreases, because of reduced movements and avoiding data transcription. It eliminates unnecessary work that does not add value, and therefore, care is improved. So, we think EHRs at the point of care should be the future or natural method for nursing to undertake. However, variables that could have a negative effect include age, night shift, and nurses’ perceptions. Therefore, it is proposed that training in the different work platforms and the participation of nurses are fundamental axes that any institution should consider before their implementation.

El objetivo de este trabajo fue conocer los recursos, flujos de trabajo y percepción de las enfermeras de una unidad de medicina interna, relacionados con los registros electrónicos, con el fin de determinar si la implantación de tablets en las unidades de hospitalización, podrían responder a sus expectativas. <br />Se llevó a cabo un estudio descriptivo, transversal, muestreo no probabilístico, consecutivo durante los meses de julio y agosto del 2016.  Se realizaron 31 observaciones, a 18 enfermeras,  392 pacientes ingresados. Las variables: turno, metodología de trabajo, tiempo “ronda”, tiempo transcripción de datos, tiempo total, número de pacientes ingresados y tiempo invertido por paciente. También se preguntó a cada enfermera sobre cómo trabajaban y el motivo.<br />La media de tiempo total fue 59,16 min (DT:16,6), y 12,65 (DT:1,11) pacientes ingresados. Tiempo invertido por paciente 4,65 min (DT:1,15), inferior en el turno tarde [M:4,14; DT: 0,84] que el de noche [M: 5,47; DT: 1,12]. El turno noche siempre utilizaba el mismo método de trabajo y era el turno tarde que presentaba sistemáticas diferentes. Las enfermeras manifestaron la necesidad de un sistema de registro ligero, en tiempo real, a pie de cama del enfermo, evitando desplazamientos, de fácil acceso para la consulta e intercambio de información. <br />Los dos métodos de trabajo de la unidad de observación no satisfacen las necesidades de las enfermeras, son lentos, pesados y dificultan el acceso a la información y el registro. La incorporación de tablets podría reducir estos problemas y cubrir sus expectativas, abriendo una nueva línea de investigación.<br /><br />