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Dashboards display hospital quality and patient safety measures aimed to improve patient outcomes. Although literature establishes dashboards aid quality and performance improvement initiatives, research is limited from the frontline nurse manager's perspective. This study characterizes factors influencing hospital nurse managers' use of dashboards for unit-level quality and performance improvement with suggestions for dashboard design. Using a descriptive qualitative design, semistructured interviews were conducted with 11 hospital nurse managers from a health system in the Midwestern United States. Thematic analysis was used to describe four perceived factors influencing dashboard use: external, data, technology features, and personal. External factors included regulatory standards, professional standards of care, organizational expectations, and organizational resources. Data factors included dashboard data quality and usefulness. Technology features included preference for simple, interactive, and customizable visual displays. Personal factors included inherent nurse manager qualities and knowledge. Guidelines for dashboard design involve display of required relevant quality measures that are accurate, timely, useful, and usable. Future research should involve hospital nurse managers in user-centered design to ensure dashboards are favorable for use. Further, opportunities exist for nurse manager informatics training and education on dashboard use in preparation for their role and responsibilities in unit-level quality and performance improvement.
Nurses faced numerous challenges during the pandemic, particularly with the increased burden of electronic documentation. Surges in patient volume and visits led to rapid changes in nursing documentation, prompting diverse responses from regulatory and healthcare organizations. Nurses expressed safety concerns and struggled with changes, calling for national standards and regulatory support. Policy relaxations, such as the 1135 Waiver, sparked debate on the future of nursing care plan documentation. Using mixed-methods exploratory design, the study identified modifications of nursing documentation during crises, commonalities in documentation burden reduction for applicability beyond pandemics, and consensus on the definition of “surge.” Documentation patterns were assessed from February to November 2022, involving 175 North American nurse leaders and informaticists. Data analysis included descriptive statistics, thematic analysis, and Pearson correlation coefficient. Significant differences were found between rural and urban settings (P = .02), with urban areas showing higher odds of changes to care plans (odds ratio, 4.889; 95% confidence interval, 1.27-18.78). Key findings highlighted the persistence of postcrisis documentation changes and varied definitions of surge criteria based on organizational leadership, policy, and mandates. The study yielded insights for modifying documentation, offering policy recommendations, and emphasizing ongoing collaboration and evidence-based approaches for future nursing practices. 
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