Project: Multi-method Evaluation of a Computer-Based Nursing Documentation System
Project team: Elske Ammenwerth (Leader), Carola Iller, Cornelia Mahler, Marianne Kandert, Gisela Luther, Ansgar Kutscha, Ulrike Kutscha, Torsten Happek, Bettina Hoppe, Ronald Eichstädter
Time span: 1998 - 2003
Cooperation partner: Heidelberg University Medical Center, Director of Nursing (Ronald Eichstädter, Bettina Hoppe)
University of Heidelberg, Institute for Med. Biometry and Informatics (Ulrich Mansmann)
University of Heidelberg, Institute for Educational Sciences (Carola Iller)

Nursing documentation is of considerable importance in clinical documentation. Documentation of the nursing process is often only inadequately supported by paper-based documentation systems. Solutions supported by IT solutions promise better support of nursing documentation. However, it is unclear whether such computer supported nursing documentation systems really lead to better support of nursing documentation and what other effects they can have.


Systematic and multi-method evaluation of computer supported nursing documentation in view of time needed for documentation, quality of documentation, user acceptance and changes in documentation and communication processes.


Carrying out diverse partial studies which employ both quantitative and qualitative methods, e.g. randomized time measurements, controlled quality measurements, validated questionnaires, group interviews, observations. The linking of results is done through triangulation.


Results up to now: The effects of computer supported nursing documentation are complex and hard to predict. They depend on numerous individual factors. Some results: A reduction in time needed for documentation can only be awaited in sub-areas. Nursing documentation becomes more extensive. A qualitative improvement can however only be seen when training accompanies the documentation process. Generally, user acceptance is high. Effects on documentation and communication processes which partially lead to a disturbance of processes could be observed

Selected Publications:

Ammenwerth E, Eichstädter R, Schrader U. EDV in der Pflegedokumentation - Ein Leitfaden für Praktiker. Hannover: Schlüterscher Verlag. Reihe pflegekolleg. 2003. ISBN 3-87706-737-9. 205 Seiten.

Ammenwerth E, Kutscha U, Kutscha A, Mahler C, Eichstädter R, Haux R. Nursing process documentation systems in clinical routine - prerequisites and experiences. International Journal of Medical Informatics 2001; 64 (2-3): 187-200.

Ammenwerth E, Mansmann U, Iller C, Eichstädter R. Factors Affecting and Affected by User Acceptance of Computer-Based Nursing Documentation: Results of a Two-Year Study. Journal of the American Medical Informatics Association 2003; 10 (1): 69 - 84.

Ammenwerth E, Mansmann U, Iller C. Can evaluation studies benefit from a triangulation of quantitative and qualitative methods? A case study. International Journal of Medical Informatics 2003; 70 (2-3): 237-48.

Ammenwerth E, Eichstädter E, Haux R, Pohl U, Rebel S, Ziegler S: A Randomized Evaluation of a Computer-Based Nursing Documentation System. Methods of Information in Medicine 2001; 40 (2): 61-68.

Ammenwerth E, Eichstädter R, Happek T, Haux R, Hoppe B, Kandert M, Kutscha A, Luther G, Mahler C, Mansmann U, Pohl U: PIK-Studie 2000/2001. Evaluation eines Pflegedokumentationssystems auf vier Pilotstationen. Abschlussbericht - Studienprotokoll und Ergebnisse. Bericht Nr. 6/2001 der Abt. Medizinischer Informatik, Universitätsklinikum Heidelberg; 2001.

(A complete list of all publications can be found on our publications page.)