The effect of a VIPS implementation programme on nurses’ knowledge and attitudes towards documentation

Scand J Caring Sci; 2004; 18; 325–332The effect of a VIPS implementation programmeon nurses’ knowledge and attitudes towardsdocumentationThe Copenhagen University Hospital decided to adhere tothe standards of the Joint Commission of InternationalAccreditation in 2000. These standards require systematicassessment of patient care needs and include the use ofwritten nursing care plans. In order to meet these stand-ards, the hospital management decided to introduce theSwedish VIPS model, which is a model designed to struc-ture nursing documentation (VIPS is an acronym for well-being, integrity, prevention and safety). The present studyexplores the nurses’ knowledge and attitudes towardsdocumentation and addresses the research questions: (a)what are the nurses’ attitudes towards documentation ofnursing care? and (b) do nurses have sufficient knowledgeof the documentation system to systematically documenttheir patient assessment and clinical decisions? Theresearch design was prospective, comparative, and quasi-experimental (nonrandomized), including a study group(n ¼ 72) and a control group (n ¼ 57). A questionnairewas used to compare nurses’ self-evaluated attitudestowards documentation, and a multiple-choice test wasgiven in order to assess nurses’ knowledge of the docu-mentation system. The study group participated in a specialimplementation programme (response rate 82%), whilethe control group attended the regular 3-day documenta-tion course at the hospital (response rate 79%). The studyshowed that the two groups responded similarly, but thenurses in the study group were significantly stronger intheir conviction that they had the knowledge to make careplans and that they routinely made them. The study groupdemonstrated slightly less motivation than the controlgroup, while the two groups shared a positive attitudetowards nursing documentation. The study group didconsistently better on the knowledge tests. The findingsshow that the implementation programme had a positiveimpactonnursingdocumentation, andthatthe VIPSmodelincreased the nurses’ understanding of the nursing process.Keywords: nursing, documentation, VIPS model, attitudeof health professional, professional education, organizationand administration, nursing process, nursing assessment,nursing diagnosis.Submitted 3 March 2004, Accepted 28 June 2004