Challenges and Impact of Transforming Paper-Based Nursing Documentation into Electronic Form: A Study in Nepal

Abstract

The healthcare sector is a very delicate sector which faces issues surrounding quality, safety, efficiency, cost, and access to health care services. The nurses have a huge responsibility to maintain quality documentation and they are struggling in doing so especially when they are still using paper-based nursing documentation. The transformation of paper-based nursing documentation into electronic form tends to increase the quality of information and thus enhances decision making and communication. This further leads to safe, ethical, and effective nursing care with optimal satisfaction of the patients and nurses. This study was carried out at B.P. Koirala Institute of Health Sciences with the aim of identifying the challenges and impact of transforming paper based nursing documentation into electronic form. A qualitative method with interpretive approach was used in this study using interview, observations, and informal discussion as data collection tool. The empirical findings were analyzed using Information Infrastructure theory and Actor-Network theory. From the empirical findings, procurement, lack of skilled manpower, electricity and connectivity problems, cost of transformation, feasibility and sustainability, high staff turnover rate, issues related to user friendliness, and issues related to change process were the major challenges identified while transforming paper based nursing documentation into electronic form. The positive impacts of the transformation outweighed the negative one. Finally, it is concluded that while using any Information Communication Technology, a proper strategic plan should be made especially in a developing country like Nepal where several challenges exists.