Presentation (CTI)

OBJECTIVES: To describe how nurses in Polish hospitals document daily activities in hospital information systems (HIS), identify the main drivers of documentation behavior, and estimate the associated time and cost burden, benchmarking per-activity documentation time against a Hungarian data.
METHODS: We surveyed 51 nurses across 29 Polish cities; 3 were excluded for missing data (N=48). Each nurse rated 204 nursing activities (9,792 observations), recording where each was documented and the time required. Proportions documenting in HIS were tested across hospital reference levels (Pearson χ²/Fisher exact) with Benjamini-Hochberg FDR correction for 204 parallel tests. K-means clustering of 204-dimensional vectors identified documentation profiles; χ² tests linked profiles to demographics. Per-activity median times were benchmarked against a Hungarian data, and national costs extrapolated from GUS wage data.
RESULTS: Across all activity responses, ~52% involved HIS, while ~34% were not reported in any system. Activities split into two groups - documented by most nurses or almost none (median 54%). Clinical safety activities were documented frequently (pressure-ulcer assessment 83%, wound dressings 78-83%); housekeeping activities rarely (cleaning, bedding 2-10%). Documentation differed by hospital reference level for 105/204 activities (75 after FDR): county and clinical (university) hospitals documented ~60% of activities versus ~25% in regional (voivodeship) hospitals. Two profiles emerged: sporadic (n=11, ~8% HIS) and intensive (n=37, ~64% HIS), with hospital reference level the only significant predictor (p=0.003). Per-activity documentation was ~10× slower in Poland than Hungary (74s vs 7s). Nationally (157,250 nurses), matching Hungarian efficiency would save ~2,900 work-hours (~156,000 PLN) per single execution of one activity.
CONCLUSIONS: HIS documentation practices are highly heterogeneous and shaped primarily by hospital reference level, not individual nurse characteristics - pointing to organizational infrastructure as the key intervention target. Standardizing procedures, improving workstation access, and facility-level training, especially in regional hospitals, could reduce documentation time and its national cost.