# Caring for Patients and Technological Competency in the Use of the Electronic Nursing Record System: A Qualitative Study

## TL;DR

This study explores how nurses balance patient care with using electronic nursing record systems, highlighting the need for better technology integration and training.

## Contribution

The study introduces a grounded theory model linking technological competency, ENRS effectiveness, and caring behavior in nursing.

## Key findings

- A core category 'Losing caring in technology-focused documentation' was identified with 17 subcategories.
- Two strategies emerged: developing technological competency and integrating caring into documentation practices.
- Consequences of poor ENRS integration were observed at individual, organizational, and national levels.

## Abstract

Background: The purpose of using an electronic nursing record system (ENRS) is to support comprehensive and accurate nursing documentation and ensure safe and high-quality patient care. This qualitative study aimed to gain an in-depth understanding of nurses’ perceptions and the interrelationships between the effectiveness of ENRS, caring behaviour, and technological competency in nursing practice. Methods: Corbin’s and Strauss’s grounded theory approach was employed. Data were collected through semi-structured interviews with eleven nurses from four Slovenian hospitals, recruited using theoretical sampling between July 2021 and July 2023. Open, axial, and selective coding were conducted using MAXQDA 2020. Results: The core category “Losing caring in technology-focused documentation” was developed, including seven categories and seventeen subcategories. The paradigmatic model identified causal conditions (inadequate ENRS effectiveness), contextual conditions (poor ENRS integration into hospital environments), and intervening conditions (patient care) that contributed to insufficient documentation of individualised and holistic care. Two action–interaction strategies were identified: developing technological competency and integrating caring into documentation practices. Consequences manifested at individual, organisational, and national levels. Conclusions: Nurses’ caring behaviour, effective ENRS, and technologically competent use of the ENRS are essential for documenting and ensuring individualised and holistic patient care.