A Mixed-Methods Systematic Review on the Impacts and Implementation of Collaborative Electronic Documentation on Nurse-Patient Relationship

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Abstract
The use of electronic health records challenges the nurse-patient relationship. Collaborative documentation could help to change this. The aim of this review was to provide a synthesis of current knowledge on the impacts, as well as barriers and facilitators of collaborative electronic documentation in nursing settings. A mixed-methods systematic review was conducted. The search was conducted in November 2022. The study used thematic analysis for qualitative data and descriptive analysis for quantitative data. Data integration was performed using a convergent integrated approach according to the Joanna Briggs Institute methodology. The methodological quality of the included studies was critically appraised using the Mixed-Methods Appraisal Tool. A total of 17 studies were included. Study types were qualitative (n = 10), quantitative (n = 2), and mixed methods (n = 5). Multiple implementation practices were identified in different types of nursing settings. The facilitators and barriers were related to characteristics of nurses, patients, technology, and organization. Education and organizational support were identified to be essential in successful implementation. Collaborative documentation could be a way to overcome the challenges in nursing process associated with electronic documentation, as it can save nurses' time and improve patient experience. Implementation needs to be carried out with end-user patients and nurses.

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