Article review of Darbyshire (2004), Computerized Patient Information System Charting

There are two key features that nurses voiced which was problematic with Computerized Patient Information System (CPIS) charting. The first disappointment was that clinicians were unable to capture the holistic nursing care perspective when documenting in the CPIS system (Darbyshire, 2004). After reviewing the article from Darbyshire (2004), There are two questions to consider:

  1. How do you make a CPIS system target toward nursing holistic care?
  2. How can we train system users to gather information efficiently when needed?

Nurses stated that what was important in nursing and the real stuff of nursing was unable to be properly documented in these computer systems (Darbyshire, 2004). It is important for these computer documentation systems to include all aspects of nursing care and not just a tick box method that they are experiencing (Darbyshire, 2004). Documentation needs a concise, accurate, comprehensive approach to provide proper nursing care documentation (Stewart et al., 2017). Nursing documentation is more than the management of physical symptoms and the documentation system used needs to reflect every aspect of nursing care (Stewart et al., 2017). Advances in this type of documentation practices and organizational support are needed to improve effective nursing documentation practices in the future (Stewart et al., 2017).

Holistic approach to be included in documentation practices

The second area of concern based on Darbyshire (2004), article is most nurses found the CPIS difficult to use and time-consuming. Nurses believed that the retrieval of information was difficult to find and that data entry is lost after submitting in the system (Darbyshire, 2004). The nurses called this a black hole phenomenon which created frustration and time-consuming effort which was void upon retrieval of information (Darbyshire, 2004). The nurse must understand the benefits of computerized charting and that once the nurse is user friendly of the computer system is will save time and provide more bedside nursing available than the pen and paper method of charting. The nurse will receive appropriate training on the computerized system and can access additional assistance if needed (Harrison, 2003). My current place of employment has a clinical nurse that is always available during the week to walk through concepts of computerized charting that we may not completely understand. Practice, proper training, and efficiency of computerized charting I believe will void the negative complaints from nurses from computerized charting (Harrison, 2003).


Darbyshire, P. (2004). “Rage against the machine?”: nurses’ and midwives’ experiences of using Computerized Patient Information Systems for clinical information. Journal of Clinical Nursing13(1), 17-25.Retrieved from

Harrison, B. (2003). Becoming familiar with computerized charting. Healthcare Traveler, 11(2), 70. Retrieved from

Stewart, K., Doody, O., Bailey, M., & Moran, S. (2017). Improving the quality of nursing documentation in a palliative care setting: a quality improvement initiative. International Journal of Palliative Nursing23(12), 577–585.


One thought on “Article review of Darbyshire (2004), Computerized Patient Information System Charting

  1. Hello Nurse Mackenzie
    Great blog on the analysis of the article. In your blog, you mention two important questions:
    How do you make a CPIS system target toward nursing holistic care?
    How can we train system users to gather information efficiently when needed?
    I believe the nurses were not trained on the benefits of using the system. The nurses mention it was time-consuming. Therefore they preferred paper documentation. In my opinion, an in-depth analysis of the nurse’s point of view should be completed, which would indicate why the nurses did not see the benefits of using CPIS. I think it would also be appropriate to obtain the age range of the nurses who did not find the system beneficial. Within my nursing practice during the EMAR/ETAR (Electronic medical records) implementation, the more senior nurses were resistive to the change and made comments such as “its too complicated,” I am too old for this nonsense”, “give me a paper medication sheet, and I am good to go.” With constant training and adjusting the EMAR, the nurses became confident in using the new system. Changes are hard especially when it requires moving from your comfort zone

    Thanks for sharing


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