Keeping accurate documentation and nursing charts of your patients' information is sound business practice for your health care facility, doctor's office or clinic. All health care personnel should be ...

"We must remember that the EHR is a tool; it should not dictate how we practice," wrote a Medscape reader. Perhaps it should not, but does it? The fact is, EHRs are far more than a method of entering ...

Nursing documentation is a cornerstone of contemporary healthcare, integrating systematic recording of patient observations, interventions, and outcomes with the aim of enhancing effective care ...

Maintaining high quality clinical documentation is essential for a number of reasons, including improved patient safety and better adherence to accreditation standards. Marie Boyd, administrator at ...

Credit: Getty Images. Providing nursing students with the opportunity to audit nursing charts in a real-world scenario may change their perspective about the charting process. The entire student audit ...

Nursing and IT leaders told Becker’s they’re working to make their EHRs friendly for nurses by involving them in the governance process, consistently soliciting feedback and using the technology to ...

Proper documentation is a necessary component of modern health care. Diligent documentation is essential for more than just good patient care. It is also the surest way to protect your professional ...

Cheristi Cognetta-Rieke, DNP, RN, vice chair for nursing at the Mayo Clinic, says nursing documentation is undergoing a "fundamental shift." At the 2026 HIMSS Global Health Conference & Exposition in ...

In one of the few recent studies to examine this question objectively, Yee and colleagues [8] assessed time spent by nurses documenting on EHRs compared with paper charting. A cross-sectional analysis ...