i n t e r n a t i o n a l j o u r n a l o f m e d i c a l i n f o r m a t i c s 8 2 ( 2 0 1 3 ) 911–921 j ourna l h omepage: www.ijmijournal.com Effects of a computerized decision support system on care planning for pressure ulcers and malnutrition in nursing homes: An intervention study Mariann Fossum a,b,* , Margareta Ehnfors a , Elisabeth Svensson c , Linda M. Hansen b , Anna Ehrenberg d a School of Health and Medical Sciences, Örebro University, Örebro, Sweden b Center for Caring Research – Southern Norway, Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway c Swedish Business School, Örebro University, Örebro, Sweden d School of Health and Social Studies, Dalarna University, Falun, Sweden a r t i c l e i n f o Article history: Received 4 January 2013 Received in revised form 28 May 2013 Accepted 30 May 2013 Keywords: Decision support system Documentation Intervention studies Malnutrition Nursing audit Pressure ulcer a b s t r a c t Background: Nursing documentation is essential for facilitating the flow of information to guarantee continuity, quality and safety in care. High-quality nursing documentation is fre- quently lacking; the implementation of computerized decision support systems is expected to improve clinical practice and nursing documentation. Aim: The present study aimed at investigate the effects of a computerized decision sup- port system and an educational program as intervention strategies for improved nursing documentation practice on pressure ulcers and malnutrition in nursing homes. Design, setting and participants: An intervention study with two intervention groups and one control group was used. Fifteen nursing homes in southern Norway were included. A con- venience sample of electronic healthcare records from 46 units was included. Inclusion criteria were records with presence of pressure ulcers and/or malnutrition. The residents were assessed before and after an intervention of a computerized decision support system in the electronic healthcare records. Data were collected through a review of 150 records before (2007) and 141 records after the intervention (2009). Methods: The nurses in intervention group 1 were offered educational sessions and were trained to use the computerized decision support system, which they used for eight months in 2008 and 2009. The nurses in intervention group 2 were offered the same educational pro- gram but did not use the computerized decision support system. The nurses in the control group were not subject to any intervention. The resident records were examined for the completeness and comprehensiveness of the documentation of pressure ulcers and mal- nutrition with three data collection forms and the data were analyzed with non-parametric statistics. Results: The implementation of the computerized decision support system and the educa- tional program resulted in a more complete and comprehensive documentation of pressure ulcer- and malnutrition-related nursing assessments and nursing interventions. ∗ Corresponding author at: Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, PO Box 509, NO-4898 Grimstad, Norway. Tel.: +47 37233756. E-mail address: mariann.fossum@uia.no (M. Fossum). 1386-5056/$ – see front matter © 2013 Elsevier Ireland Ltd. All rights reserved. http://dx.doi.org/10.1016/j.ijmedinf.2013.05.009