Peer Review: Development of an Online-based Problem-oriented Record (POR) Model and Its Impact on Nurses’ Documentation Ability

Introduction: Documentation is an essential recording and reporting activity performed by nurses,
as all nursing activities will be well-documented through recording and reporting. In hospitals, the
implementation of nursing care documentation serves as a tool for measuring and monitoring the efficacy
of nursing care services. The objective of this study was to develop a Nursing Care Instrument Design
Problem Oriented Record (POR) Online Model based on the nurses’ ability to complete the
documentations. Methods: The research designs employed were qualitative and quantitative; the population
consisted of 28 nurses, and the sample size was 15 nurses selected using a purposive sampling
strategy. Five open-ended queries were posed to the samples, which were analysed using the Collaizi
Methods. After testing the online version of the POR model, we analysed the evaluation form using a
paired t-test. Results: The Collaizi Method analysis of the interview revealed a saturation of themes
regarding the need for an online and integrated documentation system. Following this, POR Online
Model-Based was developed. The result of the paired t-test indicated that the average difference in the
ability of nurses to complete documentation prior to and after POR Online Model Based is 31.17, with
a standard deviation of 0.116. In contrast, this difference is statistically significant, with a p-value of 0.000.
It indicates that nurses will be able to complete documentations more easily after implementing POR
Online Model Based. Conclusion: The development of an online documentation system can facilitate
the documentation of nursing care by nurses and speed up the processing of nursing care services;
therefore, it is feasible to develop this system.
Keywords: Documentation; Nursing Care; POR; Online