Date Available


Year of Publication


Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Debra Hampton

Clinical Mentor

Dr. Sarah Lester

Committee Member

Dr. Alicia Farlese


Background: UK HealthCare transitioned to a new enterprise electronic health record (EHR) system, offered by Epic Systems Corporation, in June 2021. Approximately 2,000 inpatient nurses use the EpicCare Inpatient Module in the 1,086 licensed bed facilities. Compared to other academic medical centers, UK HealthCare nurses take more time documenting in this EHR inpatient module’s Basic Assessment Flowsheet (documentation burden) and have a longer delay between assessment and documentation (timeliness) potentially contributing to nursing dissatisfaction with using this new EHR.

Purpose: The purpose of this project was to evaluate the effectiveness of a phase of the Epic Nurse Well-Being Project, a nursing documentation optimization effort, implemented at UK HealthCare. Evaluation variables included nursing documentation burden and timeliness of documentation, particularly on time spent documenting in the inpatient EHR Basic Assessment Flowsheet and time from assessment to documentation.

Methods: This study employed a pre and post data design where data were obtained prior to and after an optimization phase in the Epic Nurse Well-Being Project at UK HealthCare. Epic efficiency data were collected from the Nursing Efficiency Assessment Tool (NEAT) on nursing documentation time spent in the Basic Assessment Flowsheet and time from assessment to documentation in the EHR. Data were also collected using pre and post surveys to assess the self-reported timeliness of documentation and nursing satisfaction surrounding EHR documentation.

Results: Satisfaction with the Basic Assessment documentation time in the flowsheet, satisfaction with amount of time between assessment and documentation, agreement that 3 documentation did not interfere with ability to provide patient care, and overall satisfaction with documenting in the flowsheet increased. The average time participants self-reported a delay of their Basic Assessment documentation decreased by 12.2 minutes. Epic efficiency data showed the average number of minutes spent per user per day in the Basic Assessment Flowsheet increased by 0.86 minutes, and the average number of minutes between assessment and documentation increased by 0.2 minutes after the intervention but was not statistically significant.

Conclusions: The results showed an overall positive response from participants to the intervention, although there was not a notable difference in Epic efficiency data. This project contributes valuable insights into the importance of EHR optimization for both nursing staff and patient outcomes, emphasizing the need for ongoing optimization efforts.