Using "Diraya" System as a Complementary Tool in Nursing Process Education: A Controlled Clinical Study

Background: Healthcare has been revolutionized by the application of information and communication technologies. The implementation of electronic health record systems improves the quality and safety of patient healthcare. Nursing students who start learning the nursing process without contact with real patients experience difficulties in its correct application. Purpose: To compare the acquisition of skills and competencies in the nursing process by undergraduate nursing students between conventional learning with books and learning with an academic electronic health record system (Diraya). Methods: A controlled experimental study was conducted and included 379 students with a mean age of 20.54 +/- 5.09 years, enrolled in the "Nursing Process and Basic Care" degree course at the School of Health Sciences in Granada. All participants gave their informed consent and were allocated by convenience sampling to a control group (n = 187; 21.20 +/- 5.77 years) or an experimental group (n = 192, 19.91 +/- 4.24 years). Findings: The experimental and control groups did not differ in sex distribution (p = 0.20), mean age (p = 0.01), or previous knowledge of the nursing process (p = 0.96). The groups did not significantly differ in multi-choice test results on the acquisition of theoretical knowledge (p = 0.13). However, the experimental group scored higher on clinical case planning (9.47 +/- 0.80 vs. 8.95 +/- 1.17; p < 0.001), took less time to complete it (46.9 +/- 8.76 min vs. 82.66 +/- 13.14 min; p < 0.001), and needed fewer autonomous learning hours to prepare for the final examination (2.26 +/- 2.41 vs. 9.58 +/- 3.83; p < 0.001). Satisfaction with the program and the rating of its quality were generally higher in the experimental group, while greater difficulty with most phases of the nursing process was reported by the control group. Conclusions: The academic electronic health record system "Diraya" is a useful tool to improve the learning and implementation of the nursing process by undergraduate nursing students.