When is digital documentation at its best? Swedish perioperative nurses' experiences of digital documentation and its impact at their work environment: a qualitative study.

Abstract

Digital documentation in patients' electronic medical records (EMRs) places new demands on perioperative nurses, increasing workload and cognitive strain, with subsequent technostress. While new EMR systems are implemented, they are not always adapted to users' needs. This study aimed to explore how perioperative nurses and nursing assistants describe their experiences with electronic documentation during surgery and its impact on their work environment. Additionally, it examined the emotional reactions these experiences triggered, and the adaptive strategies used to manage their effects. DESIGN: A qualitative study was conducted. Data were analysed using Braun and Clarke's thematic analysis. Two university hospitals and one county hospital in Sweden were included. 15 women and 5 men, including 9 specialist nurses in anaesthesia care, 9 nurses in operating room (OR) care and 2 nursing assistants in OR care in Sweden participated. Two main themes emerged: A-Introducing digital systems without a clear aim undermines work performance and B-Digital systems were embraced when automation and comfort were present. Subthemes included leadership and management, possibilities to develop and influence digital systems and EMRs not adapted to clinical needs. Automation from digital systems made work easier, and digital systems within one's comfort zone were appreciated. However, frustration and stress arose when aforementioned preconditions were not fulfilled, leading to adjustments to manage these challenges. Digital documentation is appreciated when fundamental conditions are met. A lack of clarity on how, what and why to document, along with insufficient training and limited ability to have an influence, triggers negative emotional reactions and unhealthy coping strategies. To enhance digital literacy, a standardised process of digital systems including digital documentation through educational efforts in which knowledge control in educational purposes is included could be tested as a potential solution.