A total of 10,947 activities were recorded for the PCs (See Table 1) and 1,500 for the RAOs (See Table 2) [14]. The proportion of time spent on documentation by the PCs increased at most measurement periods during the first 12 months after implementation. This increase may be a result of the changes in the PCs’ documentation practice; instead of documenting the care provided to each resident at least once a week, as per the policy of the RACF, the frequency of their documentation increased after system implementation. During this period, the proportion of time spent on direct care activities was reduced. This suggests that the PCs were still learning how to use the electronic nursing documentation system in their work. This finding, however, is contrary to that of Cherry et al., who found that some caregivers perceived they spent longer on direct care duties after introducing an electronic system. This variation in the findings may be attributed to differences in the study design, measurement periods, and the electronic documentation system in use. At 23 months, the PCs’ proportions of time on documentation and direct care activities had returned to pre-implementation levels.
The percentage of time spent on these activities insurance telemarketing leads by the RAOs remained unchanged at most measurement periods after the implementation of the electronic system. The finding of documentation activity may partly be attributed to the RAOs’ preferred mode of obtaining information about a resident in a work- shift. According to the interviews, the RAOs prefer oral communication to written nursing notes regardless of the documentation system in use. The caregivers’ proportion of time on communication activities remained unchanged at almost all the measurement periods after the implementation of the electronic nursing documentation system. This may be due to a lack of change in the role of verbal communication between caregivers in aged care. Indeed, in a previous study, we found that caregivers in a RACF highly value their face-to-face interaction for successful care delivery. Changes in the proportions of time on other activities were not directly associated with the introduction of the electronic nursing documentation system. The results of this study, however, may not be generalisable to other RACFs because the study was conducted at a single RACF using a particular electronic documentation system. The caregivers ‘ effective acceptance and use of such a system depends on the quality of the electronic documentation system, its ease of use, and the training provided to the caregivers.