Comparison of direct and indirect nursing-care times between physician order entry system and electronic medical records.

This study compared the amount of time spent by nursing personnel on direct and indirect nursing care between a physician order entry (POE) system and an electronic medical record (EMR) system. Nursing-care time was measured by direct observation or a self-reporting method, both using a stopwatch. Nursing activities were categorized according to modified versions of the tools reported by Park. The implementation of an EMR system increased the direct nursing-care times for all nursing positions. However, the indirect nursing-care times of head nurses and nurse aids was lower, whereas that of registered nurses was higher, and the direct and indirect nursing-care times of RNs varied with the nursing unit and shift. The increases in direct nursing times, especially that spent by nurses providing descriptions and education to patients at their bedside, led to a global improvement in the nursing quality, and the indirect nursing times varied with the nursing position.