J Am Med Inform Assoc - Intensive care unit nurses' information needs and recommendations for integrated displays to improve nurses' situation awareness.

Tópicos

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Resumo

JECTIVE: Fatal errors can occur in intensive care units (ICUs). Researchers claim that information integration at the bedside may improve nurses' situation awareness (SA) of patients and decrease errors. However, it is unclear which information should be integrated and in what form. Our research uses the theory of SA to analyze the type of tasks, and their associated information gaps. We aimed to provide recommendations for integrated, consolidated information displays to improve nurses' SA.MATERIALS AND METHODS: Systematic observations methods were used to follow 19 ICU nurses for 38 hours in 3 clinical practice settings. Storyboard methods and concept mapping helped to categorize the observed tasks, the associated information needs, and the information gaps of the most frequent tasks by SA level. Consensus and discussion of the research team was used to propose recommendations to improve information displays at the bedside based on information deficits.RESULTS: Nurses performed 46 different tasks at a rate of 23.4 tasks per hour. The information needed to perform the most common tasks was often inaccessible, difficult to see at a distance or located on multiple monitoring devices. Current devices at the ICU bedside do not adequately support a nurse's information-gathering activities. Medication management was the most frequent category of tasks.DISCUSSION: Information gaps were present at all levels of SA and across most of the tasks. Using a theoretical model to understand information gaps can aid in designing functional requirements.CONCLUSION: Integrated information that enhances nurses' Situation Awareness may decrease errors and improve patient safety in the future.

Resumo Limpo

jectiv fatal error can occur intens care unit icus research claim inform integr bedsid may improv nurs situat awar sa patient decreas error howev unclear inform integr form research use theori sa analyz type task associ inform gap aim provid recommend integr consolid inform display improv nurs samateri method systemat observ method use follow icu nurs hour clinic practic set storyboard method concept map help categor observ task associ inform need inform gap frequent task sa level consensus discuss research team use propos recommend improv inform display bedsid base inform deficitsresult nurs perform differ task rate task per hour inform need perform common task often inaccess difficult see distanc locat multipl monitor devic current devic icu bedsid adequ support nurs informationgath activ medic manag frequent categori tasksdiscuss inform gap present level sa across task use theoret model understand inform gap can aid design function requirementsconclus integr inform enhanc nurs situat awar may decreas error improv patient safeti futur

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