Article written by Dr. Girisha Vanoh, Clinical Advisor at Medanets
In 2011, a study published by Westbrook et al. revealed that nurses spent a mere 37% of their time caring for patients, while nearly two-thirds of their time was consumed by other activities. As a Clinical Advisor at Medanets, I wanted to look at a simple follow-up question. How has this changed over the past decade, especially through the lens of nursing documentation? The answer, after diving deep into recent evidence pool, is far less than optimistic. The burden of nursing documentation has remained stubbornly high over the past decade, with little evidence of meaningful improvement. The implications are concerning.
A glimpse through the studies:
- Collins et al. (2018) quantified that nurses in an acute care setting were making a whopping 631-875 data entries per 12-hour shift, which translates to an approximate of one data entry every 0.82 to 1.14 minutes.
- An interesting 120-hour observation done by Cooper et al. (2021) in a teaching hospital revealed that nurses and midwives spent an approximate average of 24.5% of their shift performing documentation, yet when requested to self-report, their estimates doubled up to 44.1% due to various challenges, such as data duplication.
- Gesner et al. (2022) bridged the long-term debatable link between clinical documentation burden and clinician burnout syndrome, proving a moderate risk between them.
- The most striking finding is presented by Lee et al. (2025), whose scoping review of 47 studies investigated a hypothesis rarely probed, whether additional nursing documentation leads to better patient outcomes. The conclusion: there is no substantial, high-quality empirical evidence suggestive of it. Nurses are spending a third of their shifts on requirements that may not, after all, improve patient care.
Why does this matter?
The impact of documentation load is not confined solely to nurse dissatisfaction. It ripples through to workflow inefficiencies and patient safety concerns. Whilst it’s understandable that this paperwork is a vital part of a patient’s journey, it is the very same aspect that plays a huge role in driving nurses away from the profession due to high burnout (Johnson et al., 2025). Data from Royal College of Nursing reveals that the number of UK-registered nurses leaving the practice within a decade of registration increased by a whopping 43% in a short time span of 3 years (2021-2024). (Royal College of Nursing, 2024).
How can this change?
Thanks to the boom in the health technology industry, various interventions targeting to mitigate this challenge are upcoming. Key players such as EPRs, mobile assistants, and AVT frequently aim to redefine healthcare workflows, ease clinical burden and improve efficiency, leading to a better healthcare delivery. However, on the flipside, this could lead to a paradoxical outcome whereby the very technological advancement could lead to additional weight sitting on nurses’ plate. Hence, it is paramount that technology is treated as a bridge that could meaningfully reduce clinical burden rather than redistribute it. Digital care delivered with human touch is the distinction that matters.
At Medanets, reducing documentation burden is not a feature. Rather, it is the founding principle. The mobile-first approach designed with clinical workflows at its heart eliminates the need for data duplication, transcription lag and integrates directly with the EHR. One of our customers, Region Skane in Sweden, concluded that the Medanets app could help them save nearly 50,000 hours a year. On top of that, they saw that the app helps them reduce the risk of erroneous documentation (Region Skåne, 2022). These hours do not disappear into an efficiency metric. They go back to the most deserving place, between a nurse and their patient.
If you work in NHS nursing workforce, EPR deployment or NHS digital transformation team, we are keen to hear from you. What does documentation burden look like in your wards? And how do you intend to tackle it? You can contact us at girisha.vanoh@medanets.com
References
Collins, S. A., Couture, B., Kang, M.-J., Dykes, P. C., Schnock, K. O., Knaplund, C., Chang, F. Y. and Cato, K. (2018). ‘Quantifying and Visualizing Nursing Flowsheet Documentation Burden in Acute and Critical Care.’ PubMed. National Institutes of Health, 2018, pp. 348–357.
Cooper, A. L., Brown, J. A., Eccles, S. P., Cooper, N. and Albrecht, M. A. (2021). ‘Is nursing and midwifery clinical documentation a burden? An empirical study of perception versus reality’. Journal of Clinical Nursing, 30 (11-12). doi: https://doi.org/10.1111/jocn.15718.
Gesner, E., Dykes, P. C., Zhang, L. and Gazarian, P. (2022). ‘Documentation Burden in Nursing and Its Role in Clinician Burnout Syndrome’. Applied Clinical Informatics, 13 (05), pp. 983–990. doi: https://doi.org/10.1055/s-0042-1757157.
Johnson, L. G., Macieira, T. G. R., Madandola, O. O., Priola, K. J. B. and Keenan, G. M. (2025). ‘Charting the path forward: Nursing perspectives on documentation and change’. Nursing Outlook. Elsevier BV, 73 (4), p. 102463. doi: https://doi.org/10.1016/j.outlook.2025.102463.
Lee, R., Thate, J. A., Withall, J., Yen, P.-Y., Cato, K. and Rossetti, S. C. (2025). ‘Relationship between additional required nursing documentation and patient outcomes: A Scoping Review’. Applied Clinical Informatics. Georg Thieme Verlag KG. doi: https://doi.org/10.1055/a-2561-3960.
Region Skåne: Ny app frigör tid i vården. Press release on 12 December 2022. https://www.mynewsdesk.com/se/region_skane/pressreleases/ny-app-frigoer-tid-i-vaarden-3223065
Royal College of Nursing. (2024). Huge increase in nurses quitting early in ‘perfect storm’ for patient care, as RCN warns NHS reforms at risk | Royal College of Nursing. The Royal College of Nursing. Available at: https://www.rcn.org.uk/news-and-events/Press-Releases/huge-increase-in-nurses-quitting-early-in-perfect-storm-for-patient-care.
Westbrook, J. I., Duffield, C., Li, L. and Creswick, N. J. (2011). ‘How much time do nurses have for patients? a longitudinal study quantifying hospital nurses’ patterns of task time distribution and interactions with health professionals’. BMC Health Services Research, 11 (1). doi: https://doi.org/10.1186/1472-6963-11-319.