In recent years, the Nursing Area of the Ente Ospedaliero Cantonale (EOC) has reached a consensus on unification of nursing language and patient-oriented documentation. This step was taken before defining future electronically based nursing documentation. In view of the increasing importance of economic aspects (e.g. DRG), a combination between nursing documentation and standardised classification for workload assessment was found in the LEP3 system. This paper discusses the principal goals and design elements of the planned solution within an electronic patient record. In the last few years the Nursing Area of EOC has embarked on a long journey as regards management, registration, planning, assessment and communication of information and nursing activities related to patient care. In this context a working document called DCOP (Patient Oriented Care Document, Documento di Cura Orientato al Paziente) has been created which is based on the principle of focus charting. This has led to unification of nursing language within EOC, including the development of specific documents for the general area, for paediatrics, the neonatal-maternal area, dialysis, intensive care and the emergency unit. The increasing use of this working instrument, concomitantly with the spread of the philosophy of care based relations, will result in a better orientation in the definition of the care processes. Today the DCOP language is used within the whole EOC and represents a solid basis on which to build the future introduction of information technology. Different studies have demonstrated that therapeutic results are influenced by the number of nurses, their mix of competences, their workload and the models applied to nursing care. It is therefore important to have an efficacious tool to measure the nurses’ workload. The current political situation and the next revision of the health insurance system (LaMal, KVG) will increase competition between the public and the private sectors. Showing the actual needs of the personnel, with a direct link to the quality of care, will become of utmost importance in dealing with the missions assigned to EOC. Within EOC there is no homogeneous instrument for this purpose, but we feel that it is absolutely necessary to have a unified system to assess workload. For all these reasons we have decided to adopt the LEP 3 system, which will have to be integrated into the electronic nursing document.
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