{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T12:13:32Z","timestamp":1788178412974,"version":"build-2803163510"},"reference-count":50,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Nursing Knowledge"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate the factors influencing the completion quality of nursing documentation (NDoc) in Romania using multilevel modeling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective descriptive study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A mixed-effect logistic regression analysis was conducted to identify factors affecting the completion of NDoc by using the Q-DIO instrument. A total of 395 NDocs were selected by probabilistic sampling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>The study identified significant correlations among the Q-DIO sub-concepts. Specifically, \u201cNursing Diagnoses as Process\u201d was significantly correlated with both \u201cNursing Diagnoses as Product\u201d and \u201cNursing-Sensitive Patient Outcomes.\u201d Additionally, \u201cNursing Diagnoses as Product\u201d is correlated with \u201cNursing Interventions.\u201d Among the external factors, the number of nurses involved in documentation was significantly linked to the completeness of both \u201cNursing Diagnoses as Product\u201d and \u201cNursing Interventions.\u201d Documentation quality also varied by hospital specialty, whereas the length of stay did not show any significant correlation with the Q-DIO sub-concepts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The relationships between Q-DIO sub-concepts underscore the importance of addressing every phase of the nursing process for meaningful nursing-sensitive patient outcomes. External factors significantly affect documentation completion, requiring the consideration of organizational aspects when implementing NDoc.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for Nursing Practice<\/jats:title>\n                    <jats:p>This study highlights the need for nurses to systematically collect and document data across all phases of the nursing process. Training and support should be provided to improve the accuracy and completeness of nursing diagnoses and their linkage to interventions and outcomes. Additionally, organizational factors, such as staffing levels and the type of hospital specialty, should be carefully considered when implementing documentation innovations, as they significantly impact the quality and completeness of NDoc.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20473087261450431","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T13:52:58Z","timestamp":1787579578000},"page":"165-175","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Investigating nursing documentation quality using Q-DIO: A multilevel regression analysis"],"prefix":"10.1177","volume":"37","author":[{"given":"Laura Elena","family":"Gligor","sequence":"first","affiliation":[{"name":"Nursing Department, Faculty of Law and Social Science, \u201c1 Decembrie 1918\u201d University of Alba Iulia, Alba Iulia, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hora\u021biu","family":"Rusu","sequence":"additional","affiliation":[{"name":"Faculty of Social Sciences and Humanities, Centre for Social Research, Lucian Blaga University of Sibiu, Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen Daniela","family":"Domnariu","sequence":"additional","affiliation":[{"name":"Dental Medicine and Nursing Department, Faculty of Medicine, Lucian Blaga University of Sibiu, Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5194-6160","authenticated-orcid":false,"given":"Maria","family":"M\u00fcller-Staub","sequence":"additional","affiliation":[{"name":"Pflege PBS (Nursing Projects, Consulting, Research), Wil, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/2047-3095.12232"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/nop2.108"},{"issue":"1","key":"e_1_3_2_4_1","first-page":"489","article-title":"Nursing documentation practices and factors impacting patient care: A systematic review","volume":"30","author":"Albahri D. 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