***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: PURPOSE Evaluate the effectiveness of body mass index ( BMI ) tables placed in exam rooms as an intervention to encourage providers to calculate and record BMI scores in patients ' medical records . DESIGN In a prospect i ve cohort design , medical record data for 276 adult patients at a federally funded community health center in New Engl and were examined from August 2000 to August 2002 following the intervention . METHODS Prominent , multicolored , laminated BMI tables were posted in the exam rooms of one of the study site 's three primary health care teams . Medical record data collected included documentation of BMI calculation in medical records , documentation of an obesity diagnosis , and inclusion of heights and current weights . Frequency distributions were calculated ; chi-square tests were used to identify associations . FINDINGS In contrast to the comparison teams , patients on the intervention team were more likely to have BMI recorded in the medical record . A statistically significant increase in the diagnosis of obesity was observed throughout the health center after the intervention . CONCLUSIONS Posting BMI tables in exam rooms contributed to increased BMI documentation in patients ' medical records Nursing documentation is an important part of clinical documentation . However , documentation of the nursing process is frequently lacking quality . There are high expectations that computer support in nursing documentation will help improve documentation quality . This study aim ed to examine whether the introduction of a computer based nursing documentation system can improve documentation quality . A prospect i ve intervention study was conducted on 4 wards of the University Medical Center Heidelberg over a period of 18 months . Two wards in the Psychiatric University Medical Center Heidelberg were involved in the research study , as well as a dermatological and a pediatric ward . The results of the study show a significant improvement of documentation quantity and quality on three of the four wards . Positive aspects include completeness of documentation on the nursing process , formal aspects and subjective quality improvement by the nurses . Negative aspects were mainly associated with the contents of the care plans 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 PURPOSE To evaluate the impact of the quality of nursing diagnoses , interventions , and outcomes in an acute care hospital following the implementation of an educational program . METHOD In a pretest-posttest experimental design study , nurses from 12 wards of a Swiss hospital received an educational intervention -- an introductory class and consecutive classes , using a case discussion method --to implement nursing diagnoses , interventions , and outcomes .  Two sets of 36 r and omly selected nursing records were evaluated before and after implementation . The quality of documented nursing diagnoses , interventions , and nursing-sensitive patient outcomes was assessed by 29 Likert-type items with a 0 - 4 scale instrument , called Quality of Nursing Diagnoses , Interventions , and Outcomes ( Q-DIO ) and tested using t-tests . FINDINGS Significant enhancements in the quality of documented nursing diagnoses , interventions , and outcomes were found following the implementation of a planned educational program . CONCLUSIONS The implementation of N AND A , NIC , and NOC ( NNN ) nursing diagnoses , interventions , and outcomes led to higher quality of nursing diagnosis documentation , etiology-specific nursing interventions , and nursing-sensitive patient outcomes . IMPLICATION S FOR NURSING PRACTICE Educational measures support nurses to improve documentation of diagnoses , interventions , and outcomes . The Q-DIO is a useful audit tool 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 undertaken in an acute care hospital was to evaluate sensitivity and specificity of the documentation of nurse-reported delirium symptoms in medical charts .  This is a descriptive study based on the clinical assessment s of a study nurse and nursing notes in the medical charts of 226 delirious older patients newly admitted to an acute care hospital . The results of this prospect i ve validation study indicated that documentation of delirium symptoms is poor . Disorientation , agitation and altered level of consciousness were the three symptoms yielding a higher level of sensitivity , but even so said symptoms were reported in less than a third of the medical charts . Univariate analysis suggested that higher comorbidity level , more severe symptoms of delirium and the use of physical restraints were associated with more valid documentation of delirium symptoms in medical charts . Lastly , this study corroborates results of previous studies , indicating that documentation of delirium symptoms in medical charts can be improved . Future study should target improving nurse documentation of delirium symptoms in medical charts 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 PURPOSE To describe pilot testing of Quality of Diagnoses , Interventions and Outcomes ( Q-DIO ) , an instrument to measure quality of nursing documentation .  DESIGN Instrument testing was performed using a r and om , stratified sample of 60 nursing documentations representing hospital nursing with and without implementation of st and ardized nursing language ( 30 for both strata ) in a Swiss General Acute Hospital . METHODS Internal consistency and intrarater and interrater reliabilities were tested . Through item analyses , the grade s of difficulty and the discrimination validity of items were evaluated . FINDINGS Internal consistency of nursing diagnoses as process produced Cronbach 's alpha .83 ; nursing diagnoses as product .98 ; nursing interventions .90 ; and nursing-sensitive patient outcomes .99 . With Kappas of .95 , the intrarater and interrater reliabilities were good . Criteria for the grade s of difficulty of items and discrimination validity were well met . The results of this study suggest that Q-DIO is a reliable instrument to measure the documentation quality of nursing diagnoses , interventions , and outcomes . Further testing of Q-DIO in other setting s is recommended AIM This paper is a report of a study to investigate the effect of guided clinical reasoning . This method was chosen as a follow-up educational measure ( refresher ) after initial implementation of st and ardized language . BACKGROUND Research has demonstrated nurses ' need for education in diagnostic reasoning to state and document accurate nursing diagnoses , and to choose effective nursing interventions to attain favourable patient outcomes . METHODS In a cluster r and omized controlled experimental study , nurses from three wards received guided clinical reasoning , an interactive learning method . Three wards , receiving classic case discussion s , functioned as control group . Data were collected in 2004 - 2005 . The quality of 225 r and omly selected nursing records , containing 444 documented nursing diagnoses , corresponding interventions and outcomes was evaluated by applying 18 Likert-type items with a 0 - 4 scale of the instrument Quality of Nursing Diagnoses , Interventions and Outcomes . The effect of guided clinical reasoning was tested against classic case discussion s using T-tests and mixed effects model analyses . FINDINGS The mean scores for nursing diagnoses , interventions and outcomes increased significantly in the intervention group . Guided clinical reasoning led to higher quality of nursing diagnosis documentation ; to aetiology-specific interventions and to enhanced nursing-sensitive patient outcomes . In the control group , the quality was unchanged . CONCLUSION Guided clinical reasoning supported nurses ' abilities to state accurate nursing diagnoses , to select effective nursing interventions and to reach and document favourable patient outcomes . The results support the use of the North American Nursing Diagnosis Association , Nursing Interventions Classification and Nursing Outcomes Classification classifications and demonstrate implication s for the electronic nursing documentation 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 AIM The aim was to implement and evaluate a st and 
    Output:
    
Flaws of nursing documentation were identified and the effects of study interventions on its quality .