The effect of a VIPS implementation programme on nurses’ knowledge and attitudes towards documentation Mette Rosendal Darmer MNS, RN (Project Leader), Lena Ankersen RN, Bettina Geissler Nielsen RN, Gitte Landberger RN, Elisabeth Lippert RN and Ingrid Egerod PhD, MNS, RN (Associate Professor) Copenhagen University Hospital, Copenhagen, Denmark Scand J Caring Sci; 2004; 18; 325–332 The effect of a VIPS implementation programme on nurses’ knowledge and attitudes towards documentation The Copenhagen University Hospital decided to adhere to the standards of the Joint Commission of International Accreditation in 2000. These standards require systematic assessment of patient care needs and include the use of written nursing care plans. In order to meet these stand- ards, the hospital management decided to introduce the Swedish 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 study explores the nurses’ knowledge and attitudes towards documentation and addresses the research questions: (a) what are the nurses’ attitudes towards documentation of nursing care? and (b) do nurses have sufficient knowledge of the documentation system to systematically document their patient assessment and clinical decisions? The research design was prospective, comparative, and quasi- experimental (nonrandomized), including a study group (n ¼ 72) and a control group (n ¼ 57). A questionnaire was used to compare nurses’ self-evaluated attitudes towards documentation, and a multiple-choice test was given in order to assess nurses’ knowledge of the docu- mentation system. The study group participated in a special implementation programme (response rate 82%), while the control group attended the regular 3-day documenta- tion course at the hospital (response rate 79%). The study showed that the two groups responded similarly, but the nurses in the study group were significantly stronger in their conviction that they had the knowledge to make care plans and that they routinely made them. The study group demonstrated slightly less motivation than the control group, while the two groups shared a positive attitude towards nursing documentation. The study group did consistently better on the knowledge tests. The findings show that the implementation programme had a positive impact on nursing documentation, and that the VIPS model increased the nurses’ understanding of the nursing process. Keywords: nursing, documentation, VIPS model, attitude of health professional, professional education, organization and administration, nursing process, nursing assessment, nursing diagnosis. Submitted 3 March 2004, Accepted 28 June 2004 Introduction An ongoing quest to improve nursing documentation has been evident over the years in many countries. For this and other reasons, the hospital management at the Copenhagen University Hospital committed themselves to adhere to the standards of the Joint Commission of International Accre- ditation in 2000 (1). These standards require systematic assessment of patient care needs and include the use of written nursing care plans. A documentation system inclu- ding nursing care plans was needed in order to meet the standards. The VIPS model is a systematic method of nursing documentation that has been demonstrated to improve the quality of documentation and sustain the quality of nursing care (2–4). Because of the wavering quality of nursing documentation, and the pending implementation of a computerized information system, the hospital manage- ment decided in 2001 to introduce the VIPS model. International studies regarding nursing documentation have shown that nurses often fail to complete all the stages in the nursing process; limiting themselves to patient assessment, and falling short when it comes to formulating nursing diagnoses (3, 5, 6), creating and updating nursing care plans (4), and linking assessment, diagnosis and interventions (6). Nurses usually complete a patient status, but the information is insufficient in order to formulate a nursing diagnosis and care plan, although nurses regard the nursing journal as a mark of professionalism (7). Correspondence to: Ingrid Egerod, The University Hospitals Centre for Nursing and Care Research, Copenhagen University Hospital, Section 7331, Blegdamsvej 9, DK-2100 Copenhagen O, Denmark. E-mail: ingrid@ucsf.dk Ó 2004 Nordic College of Caring Sciences, Scand J Caring Sci; 2004; 18, 325–332 325