Carolinas Medical Center had for several years relied on a good old-fashioned paper chart for documenting one important aspect of care-nursing presence at the bedside. The center had an inpatient EHR in place, but the system did not include appropriate data fields to capture information about the hourly rounding of nurses-a time standard the organization put in place as part of an overall quality improvement initiative around nurse rounding back in 2004. "On the paper form, we documented what time the nurse arrived and what problem they addressed, such as bathroom use," says Kyla Slagter, R.N., clinical nurse specialist.
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