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All Journal International Journal of Nursing and Health Services (IJNHS)
Effy Afifah
Basic and Fundamental Nursing Department Faculty of Nursing Universitas Indonesia
Health Professions Nursing Public Health Social Sciences

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IMPROVEMENT LEGAL ASPECTS AND COMPLETENESS OF DOCUMENTATION USING RECORD: A REPORT OF STUDY: DOI: https://doi.org/10.35654/ijnhs.v1i2.46 Rr.Tutik Sri Hariyati; Krisna Yetti Malawat; Retno Purwandari; Effy Afifah
International Journal of Nursing and Health Services (IJNHS) Vol. 1 No. 2 (2018): International Journal of Nursing and Health Services (IJHNS)
Publisher : Alta Dharma Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (244.684 KB) | DOI: 10.35654/ijnhs.v1i2.46

Abstract

Background: Completeness of documentation as a legal aspect and proof a nursing activity. Nothing documentation means nothing activity.Objective: The Purpose of research to identify the legal aspect and completeness of nursing documentation after applying electronic nursing documentation. Methods: Report study approach and using pre and post-test with the control group. Thirty Four documentation collected using consecutive sampling on one-week observation before and after using electronic nursing information. The research compared the legal aspect and completeness of data conducted before and after the implementation of the new system.Results: The study showed improvement of the legal aspects increased by 50% (4,40 to 8,00) and completeness documentation by 10.39% (43,00 to 49,00) after used of a system. Conclusion: Nursing Electronic Documentation improved legal aspect, completeness nursing and enhance the quality of nursing care. Recommendation: Electronic nursing documentation can be done to support and increase the quality of nursing.
Co-Authors Krisna Yetti Malawat Retno Purwandari Rr.Tutik Sri Hariyati