Effectiveness of a support manual for the correct filling of the Nursing sheet

Abstract

The present research has emerged for the desire

to meet the fulfillment grade of the nursing sheet,

because in the training, the students had sight

that do not exists a standard for filling the clinical

records, which is important for the medical records,

satisfy the function in a multidisciplinary report the

patients evolution.

Objective: To decide the effectivity of the manual

with support for the accurate filling of the clinical

records, moreover, explore which are the facts in the

point of view of the nursing professionals, influence

in the correct fill.

Methodology: Design quantitative, prospective,

longitudinal, analytical and experimental with

application scope, Present; 13 nurses of second level

of hospital attention, in the Mexican health system,

working in the Internal Medicine and General

Surgery, with a work experience more than 5 years.

Results: We regard the association between the

knowledge level of nurses and the correct filling of

the clinical records, at the same time with the manual

implementation, we noted the filling improvement.

Discussion: Our results match with other research

by others authors who mention that are several

facts that alter the nursing sheet fill, appearing like

principal fact on knowledge level which has the

professional.

Conclusion: The manual proposed in this research

is effective to promote the correct fill of the clinics

records.