***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The accuracy of  patient records in Swedish nursing homes : congruence of record content and nurses ' and patients ' descriptions . Data from patient records will increasingly be used for care planning , quality assessment , research , health planning and allocation of re sources . Knowledge about the accuracy of such secondary data , however , is limited and only a few studies have been conducted on the accuracy of nursing recording . The aim of this study was to analyse the concordance between the  nursing documentation  in nursing homes and descriptions of some specific problems of nurses and patients . Comparisons were made between wards where nurses had received training in structured recording based on the nursing process ( study group ) and wards where no intervention had taken place ( reference group ) . Data were collected from the patient records of r and omly selected nursing home residents ( n=85 ) . The methods used were audits of patient records and structured interviews with residents and nurses . The study revealed considerable deficiencies in the accuracy of the patient records when the records were compared with the reports from nurses and residents . The overall agreement between the interview data from nurses and from the patient records was low . Concordance was better in the study group as compared with the reference group in which the recorded data were structured only following chronological order . The study unequivocally demonstrates that there are major limitations in using records as a data source for the evaluation , planning and development of care OBJECTIVES To assess the agreement between falls as recorded in the Minimum Data Set ( MDS ) and fall events abstract ed from chart documentation of elderly nursing home ( NH ) residents . DESIGN Secondary analysis of data from a longitudinal panel study . SETTING Fifty-six r and omly selected NHs in Maryl and stratified by facility size and geographic region . PARTICIPANTS Four hundred sixty-two NH residents , aged 65 and older , in NHs for 1 year . MEASUREMENTS Falls were abstract ed from resident charts and compared with  MDS fall variables . Fall events data  obtained from other sources of chart documentation were matched for the corresponding periods of 30 and 180 days before the 1-year MDS assessment date . RESULTS For a 30-day period , concordance between the MDS and chart abstract ions of falls occurred in 65 % of cases , with a kappa coefficient of 0.29 ( P<.001 ) , indicating fair agreement . Concordance occurred between the sources for 75 % of cases for a 180-day period , with a kappa of 0.50 ( P<.001 ) , indicating moderate agreement . During the 180-day period , chart abstract ions showed that 49 % of the sample fell , whereas the MDS revealed that only 28 % fell . An analysis of residents whose falls the MDS missed indicated that these residents had significantly more activity of daily living impairment and significantly less unsteady gait and cane/walker use . CONCLUSION The MDS underreported falls . Nurses completing MDS assessment s must carefully review residents ' medical records for falls documentation . Future studies should use caution when employing MDS data as the only indicator of falls A two-month r and omized , controlled trial based on 60 patients has been performed on a ward of the Department of Psychiatry at Heidelberg University Medical Center , Germany , to investigate the influence of computer-based nursing documentation on time investment for documentation , quality of documentation and user acceptance . Time measurements , question naires , documentation analysis and interviews were used to compare patients documented with the computer-based system ( PIK group ) with the control group ( patients documented with the paper-based system ) .  The results showed the advantages and disadvantages of computer-based nursing documentation .  Time needed for nursing care planning was lower in the PIK group . Some formal aspects of quality were considerably better in the PIK group . On the other h and , time required for documentation of tasks and for report writing was greater in the PIK group . User acceptance increased significantly during the study . The interviews indicated a positive influence of PIK on the cooperation between nurses and physicians The purpose of this study was to determine how use of a st and ardized nomenclature for nursing diagnosis and intervention statements on the computerized nursing care plan in a long-term care ( LTC ) facility would affect patient outcomes , as well as organizational processes and outcomes . An experimental design was used to compare the effects of two methods of documentation : Computer care plan and paper care plan .  Twenty participants ( 10 in each group ) were r and omly assigned to either group . No statistically significant differences were found by group for demographic data . Repeated measures ANOVA was computed for each of the study variables with type of care plan , written or computerized , as the independent variable . There were no statistically significant differences between participants , group ( care plan ) , within subjects ( across time ) , or interaction ( group and time ) effects for the dependent variables : Level of care , activities of daily living , perception of pain , cognitive abilities , number of medications , number of bowel medications , number of constipation episodes , weight , percent of meals eaten , and incidence of alteration in skin integrity . There were significantly more nursing interventions and activities on the computerized care plan , although this care plan took longer to develop at each of the three time periods . Results from this study suggest that use of a computerized plan of care increases the number of documented nursing activities and interventions , but further research is warranted to determine if this potential advantage can be translated into improved patient and organizational outcomes in the long-term care setting This study investigated whether district nurses ' opinions changed after the education and introduction of  district nurses  as ' pain-advisers ' at primary health care centres ( PHCCs ) regarding working conditions and satisfaction with pain control management at their PHCCs , their own knowledge of pain control and satisfaction with their own pain control management , pain assessment and nursing documentation of patients with chronic pain conditions . A study area ( SA ) with five PHCCs and a control area ( CA ) with seven PHCCs were selected . In the SA , 28 and in the CA , 25 district nurses answered a question naire both before and after the introduction of the ' pain-advisers ' into the SA . The district nurses in both areas in 1996 and 1998 considered many aspects of pain management to be unsatisfactory . According to the district nurses in the SA , several statistically significant improvements were achieved after the introduction of the ' pain-advisers ' ; more district nurses reported that pain policies or other written information were now available at their PHCCs , that they were more satisfied with present overall routines at their PHCCs , that a better pain control was applied at their PHCCs regarding patients with leg ulcers , that they themselves to a greater extent performed individual pain assessment s of the patients and that they more often used pain visual analogue scales to assess the patients ' pain and to evaluate the results of the pain treatment . They also reported an increased satisfaction with their own nursing documentation . Although much remains to be done , it must be acknowledged that the ' pain-advisers ' , with relatively small re sources , managed to make significant improvements The purpose of this analysis was to evaluate documentation of practice provided by a multidisciplinary team of nurses , physicians , and pharmacists who participated in an educational program on postoperative pain management .  Chart audit of 787 patient charts at 6 sites revealed documentation of pain histories in approximately 75 % of the charts , most often in the surgeon 's history and physical examination . Examination of multiple assessment items indicated that the experimental group , relative to the control group , experienced an increase of more than 10 % in the documentation of pain intensity , pain quality , pain duration , numeric rating scale used , pain behavior , factors that increase pain , vital signs , sedation level , cognitive status , social interaction , and mood from before the program to 6 months after the program . Across all sites , documentation of assessment , treatment , and treatment outcome data was infrequent and inconsistent . Calculation of documentation of 4 items that constituted a focused assessment of postoperative pain on the surgical floor revealed a significant program effect for assessment of pain quality and pain intensity . A postprogram survey of participants in the educational program revealed an increase in discussion of postoperative pain management with other practitioners and an increase in use of a 0 to 10 scale to rate pain . More documentation of patient pain history , clinical problems , treatment , and follow-up action is needed to improve practice and research AIM AND OBJECTIVES The aim of this paper is to present a study describing nurses ' adherence to the VIPS model by evaluating the quality of nursing assessment , and the quantity of completed nursing care plans . BACKGROUND Numerous efforts have been made over the years to improve nursing documentation in Denmark . Hospitals have traditionally based nurses ' charting on a rudimentary version of the nursing process and on Virginia Henderson 's theory of human needs . In 2002 - 2004 the Copenhagen University Hospital , Rigshospitalet , introduced the Swedish VIPS model for nursing documentation . VIPS is an acronym for well being , integrity , prevention and safety , all of which are seen as major goals for nursing care . The model organizes nursing data according to a system of keywords , which facilitates storage and retrieval of data . DESIGN AND METHODS The design in this part of the study was retrospective , wherein 50 journals from each of the departments of cardiology , neurology , oncology and urology were audited annually for three years using the Cat-ch-Ing instrument ( n=600 ) . All nursing journals were r and omly selected by including the first 50 journals at each site given a specific date . RESULTS The nursing documentation significantly improved during the course of the study . After the second year the participants used the keywords appropriately and correctly according to the VIPS model . Application of primary nursing increased during the study . Initial , ongoing and discharge patient status improved . The nurses ' familiarity with nursing diagnoses , goals and interventions increased . CONCLUSIONS The structured implementation programme significantly improved nursing documentation , and the simultaneous training of the entire nursing staff shows promise . The VIPS model has prepared the nurses for more complex computerized taxonomies and classification systems in the future by improving the nurses ' analytical skills . Relevance to clinical practice . New strategies for improving nursing documentation have been demonstrated The Copenhagen University Hospital decided to adhere to the st and ards of the Joint Commission of International Accreditation in 2000 . These st and ards require systematic assessment of patient care needs and include the use of written nursing care plans . In order to meet these st and ards , the hospital management decided to introduce the Swedish VIPS model , which is a model design ed to structure nursing documentation ( VIPS is an acronym for well-being , integrity , prevention and safety ) . The present study explores the nurses ' knowledge and attitudes towards documentation  and addresses the research questions : ( a ) what are the nurses '  attitudes towards documentation of nursing care ? and ( b ) do nurses have sufficient knowledge of the documentation system to systematic ally document their patient assessment and clinical decisions ? The research design was prospect i ve , comparative , and quasi-experimental ( nonr and omized ) , including a study group ( n=72 ) and a control group ( n=57 ) . A question naire was used to compare nurses ' self-evaluated attitudes towards documentation , and a multiple-choice test was given in order to assess nurses ' knowledge of the documentation system . The study group participated in a special implementation programme ( response rate 82 % ) , while the control group attended the regular 3-day documentation course at the hospital ( response rate 79 % ) . The study showed that the two groups responded similarly , but the nurses in the study group were significantly stronger in their conviction that they had the knowledge to make care plans and that they routinely made them . The study group demonstrated slightly less motivation than the control group , while the two groups shared a positive attitude towards nursing documentation . The study group did consistently better on the knowledge tests . The findings show that the implementation programme had a positive impact on nursing documentation , and that the VIPS model increased the nurses ' underst and ing of the nursing process The aims of the study were to investigate , on a daily basis : ( i ) the development and progress of pressure ulcers , ( ii ) the documented nursing interventions for prevention and treatment of pressure ulcers , and ( iii ) when nursing interventions regarding prevention and treatment of pressure ulcers were documented , in relation to patient risk status and the development of pressure ulcers . The study design was prospect i ve , comparative and descriptive . A total of 55 patients with hip fracture were included . To facilitate the nurse 's assessment , a ' pressure ulcer card ' was developed , consisting of the Modified Norton Scale ( MNS ) and descriptions of the four stages of pressure ulcers . The incidence of pressure ulcers was 55 % . The mean rank of the lowest MNS score was significantly lower for patients who developed pressure ulcers than for patients without pressure ulcers . The majority of the pressure ulcers occurred between admission to the ward and the fourth day after surgery . Documented interventions regarding prevention and treatment were :  repositioning , overlays , cushions , use of lotion and observation .  The mean number of interventions per patient was 2.2 for patients who developed pressure ulcers during their hospital stay . The comprehensiveness and quality of the nursing record was unsatisfactory , and only three nursing records reached the level required by Swedish law . Preventive interventions such as repositioning were documented when the pressure ulcer had already occurred . The lack of nursing documentation regarding prevention and treatment of pressure ulcers may indicate that nurses did not identify pressure ulcers as a prioritized nursing problem for this patient group . The Modified Norton Scale could be a valuable tool for nurses , both identifying the patient at risk and acting as a guide for nursing interventions . The study was approved by the ethics committee of the Faculty of Medicine at Uppsala University 
    Output:
    
Studies classified under the heading of st and ardized documentation showed more positive than negative effects with respect to quality , the nursing process and terminology use , knowledge level and acceptance of computer use in documentation .