THE RELATIONSHIP BETWEEN HYBRID DOCUMENTATION PRACTICES AND NURSES' COGNITIVE LOAD IN HOSPITAL INPATIENT WARDS

Abstract

The incomplete transition to Electronic Medical Records (EMRs) has required nurses to continue performing hybrid documentation, using both paper-based and electronic documentation systems simultaneously. This practice may increase nurses' cognitive load due to duplicate documentation across two different media. This research aimed to examine the relationship between hybrid documentation practices and nurses' cognitive load in the inpatient wards of RS AM. This research employed a correlational cross-sectional design. A total of 92 nurses were selected using proportionate stratified random sampling. Data were collected using the Hybrid Documentation Practices Questionnaire and the National Aeronautics and Space Administration Task Load Index (NASA-TLX). The data were analyzed using the Pearson product-moment correlation test. The results showed that hybrid documentation practices were categorized as high, with a mean score of 36.61. Nurses' cognitive load was also categorized as high, with a mean score of 71.18. Among the six dimensions of the NASA-TLX, the effort dimension demonstrated the highest mean score (79.75). Pearson correlation analysis revealed a significant positive correlation between hybrid documentation practices and nurses' cognitive load (r = 0.363, p < 0.001). These findings indicate that higher levels of hybrid documentation practices are associated with greater perceived cognitive load among nurses. Therefore, optimizing the full implementation of EMRs should be considered to reduce nurses' cognitive load, improve documentation efficiency, and enhance patient safety.