What are the barriers and enablers to using the focus charting format in the hospital setting?
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Other Title
Authors
Richards, Timothy
Author ORCID Profiles (clickable)
Degree
Master of Nursing
Grantor
Eastern Institute of Technology
Date
2013
Supervisors
Papps, Elaine
Forrest, Rachel
Forrest, Rachel
Type
Masters Thesis
Ngā Upoko Tukutuku (Māori subject headings)
Keyword
New Zealand
hospitals
nursing documentation
focus charting
effectiveness
barriers
enablers
surveys
hospitals
nursing documentation
focus charting
effectiveness
barriers
enablers
surveys
ANZSRC Field of Research Code (2020)
Citation
Richards, T. D. (2013). What are the barriers and enablers to using the focus charting format in the hospital setting? (Unpublished document submitted in partial fulfilment of the requirements for the degree of Master of Nursing). Eastern Institute of Technology (EIT), New Zealand.
Abstract
INTRODUCTION
Nursing documentation is an important factor in providing safe and effective healthcare to patients. In a review of nursing documentation at a large hospital in New Zealand, it was noted that there was sparse patient focused information and a fragmentation of the nursing process. A Nursing Practice Development (NPD) team set up a project to identify and implement a documentation framework that would encourage critical thinking and provide evidence of the rationale for nursing actions utilising a problem based approach, in order to provide accurate evidence of patient progress. After a comprehensive literature review, the NPD team decided to introduce the focus charting format for nursing documentation. Unfortunately there was limited literature on the effectiveness of such charting formats thus this research was undertaken to fill the gap.
RESEARCH QUESTION/PURPOSE OF RESEARCH
The research undertaken for this thesis sought to formally identify, ‘What are the barriers and enablers to using the focus charting format in the hospital setting’.
METHOD
Both quantitative and qualitative data were collected using an electronic questionnaire on Survey Monkey, a hard copy of the questionnaire and a documentation review. The number of nurses sent the questionnaire was approximately 300. A documentation review was completed on nine wards within the hospital where the focus charting format is used and 45 individual nursing entries were reviewed.
RESULTS/FINDINGS
The response rate from the questionnaire was 48% (n=145). Fifty one per cent of participants believed they had adequate education to successfully use focus charting, however, a common theme from the participants comments that was identified as a barrier to its successful use, was insufficient education and on-going support. Another common theme was different interpretations by nurses about how to use the focus charting format. Some nurses thought lack of time was a barrier whereas others perceived having more time was an enabler. Sixty six per cent of participants believed using the focus format improved the quality of nursing documentation. Significantly (P < 0.05) more positive responses were received from nurses with less than 5 years experience, compared to those with more than 10 years experience regarding adequate focus charting education, focus charting assisting the quality of nursing record, the ease of review, retrieving information and complimenting care plans.
CONCLUSIONS
Adequate training of new nurses, regular education of existing nurses and on-going support is an enabling factor in improving and maintaining quality nursing documentation. Barriers to using focus charting are insufficient education and different interpretations on how to use the format. There needs to be a consistent approach with focus charting education and those who teach it to avoid different interpretations. Regular audits of the nursing documentation need to continue; this will help with consistent timely improvements, and maintain a high standard of documentation.
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