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Improving the quality of newborn feeding documentation in an EHR using a mixed methods approach
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Date
2024-07-24
Authors
Sheehan, Orla Maria
Greene, Richard A.
Corcoran, Paul
McKernan, Joye
Murphy, Brendan
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier Ltd.
Published Version
Abstract
Introduction: Newborn feeding is key to infant growth and survival. Accurate feeding documentation can inform care decisions and planning of care. A nutritional dashboard is available within the Electronic Health Record (EHR) which accumulates feeding data in a graphical display. Purpose: To improve the quality of newborn feeding documentation for post-natal ward babies and babies in the Neonatal Intensive Care Unit (NICU). Design and Methods: A multidisciplinary end user expert group (n = 38) was established. Qualitative thematic analyses from this group were used to design new feeding data entry and review elements. Quantitative pre-post design was used to assess feeding documentation for both post-natal ward baby charts (n = 134) and NICU baby charts (n = 188). Descriptive statistics and Pearson's chi-square were used to assess pre-post differences and statistical significance. The use of a nutritional dashboard was assessed using system audit logs and analyzed using Poisson regression testing. Results: Post-natal ward babies had improvements in structured feeding documentation by 91.6% (from 17.9% to 34.3%) (p = 0.031). NICU data feeding documentation improved by 25% (from 72.3% to 90.4%) (p = 0.001). Use of the nutritional dashboard however reduced in the post period. Conclusion: This study has positively demonstrated improvements in the quality of newborn feeding documentation within the patient's EHR can be achieved through a collaborative multidisciplinary approach optimising EHR design. Practice implications: The benefit of a multidisciplinary approach to EHR design is paramount to promoting superior quality data entry compliant with individual workflows.
Description
Keywords
Newborn feeding , EHR , Electronic health record , Data quality , NICU feeding , Optimisation
Citation
Sheehan, O. M., Greene, R. A., Corcoran, P., McKernan, J. and Murphy, B. (2024) 'Improving the quality of newborn feeding documentation in an EHR using a mixed methods approach', Journal of Neonatal Nursing. https://doi.org/10.1016/j.jnn.2024.07.025