Nurses’ experiences of adopting a digital record keeping system: a mixed-methods evaluation of the Welsh Nursing Care Record

Background/Aims In 2021, the Welsh Nursing Care Record (WNCR) was introduced as the first digital nursing record system in Wales. This evaluative study aimed to explore the experiences of nurses of the implementation process and use of this electronic health record system. Methods This mixed-methods design involved six of the 10 hospital sites that had taken part in the implementation of the WNCR in one health board in Wales. All nurses working in wards where the WNCR had been implemented were invited to participate in a 32-item survey, comprising open and closed questions. Respondents were asked to volunteer to participate in semi-structured interviews to discuss their experiences in more depth. Quantitative data were analysed descriptively while qualitative data were analysed thematically. Results Of the 86 survey respondents, most had completed the training offered by the internal implementation team. Negative experiences with the WNCR were mostly related to IT and hardware issues, such as slow log in processes and lack of available devices. In both the surveys and interviews, improved quality of records was noted as a key benefit for the WNCR, while challenges included other areas of nursing care not being included in the digital system, and the issues related to running paper-based and digital systems in parallel. Conclusions Nurses’ experiences of the WNCR in its early stages were mixed, but most participants reported benefits, including improved care record quality. Training and support during implementation emerged as an important factor, while IT issues and the interface with other paper-based systems were key frustrations. Implications for practice When undertaking digital change, a training needs analysis should be considered in order to understand existing digital skills and support needs among staff. Communication and collaboration with clinicians and other stakeholders is also crucial throughout the process, from inception to launch, and through ongoing integration.