Effects on the quality of the nursing care process through an educational program and the use of electronic nursing documentation.

Purpose: To evaluate the effect of the educational program "Guided Clinical Reasoning" (GCR) and the introduction of an intelligent electronic nursing documentation system (e-doc) on the quality of the nursing process.

Methods: Evaluation was conducted at three measurement points and rated with the instrument "Quality of Nursing Diagnoses, Interventions and Outcomes" (Q-DIO).

Findings: GCR showed the best Q-DIO-scores. No long-term effect was found after GCR cessation. The e-doc delivered the lowest scores, while showing adequate support in using nursing diagnoses.

Conclusions: E-docs can support conducting the nursing process, but for meaningful e-doc use, clinical reasoning is essential.

Implications: High-quality nursing documentation requires recognition of factors obstructing or supporting nurses in the use of e-docs while conducting the nursing process.