All ETDs from UAB

Advisory Committee Chair

Jacqueline Moss

Advisory Committee Members

Eta S Berner

Rebecca S Miltner

Penni Watts

Marisa Wilson

Document Type

Dissertation

Date of Award

2017

Degree Name by School

Doctor of Philosophy (PhD) School of Nursing

Abstract

Errors during the course of clinical practice are common and can lead to adverse events in hospitalized patients. Insufficient information and lack of clinician knowledge can serve as major contributing factors to the incidence of errors that occur during patient care. Nurses at the bedside need immediate access to patient specific information, at the point of care, and in an easily accessible format. There is a need for better understanding of the information needs and information-seeking behaviors of medical-surgical nurses. The purpose of this mixed-methods study was to explore the information-seeking behaviors of nurses when delivering patient care on medical-surgical units to inform the development of clinical decision support systems for medical-surgical acute care nurses. Twenty-five medical surgical nurses were observed for 4-hour observation sessions and then participated in semi-structured post-observation interviews. Each information-seeking episode initiated by the nurses was categorized by the need-creating event, the type of information accessed, the source of information, and the mode/format of information exchange though a computerized observational data collection tool. Semi-structured interviews provided more information regarding unmet information needs, information source preferences, perceptions of accessibility and ease of use of sources, and personal experiences with information-seeking. Findings revealed that nurse most often search for information in order to support the patient treatment and the provision of patient care. Information regarding current and new orders and the schedule of patient care were the most frequently accessed types of information. Nurses in this study most often accessed electronic sources and utilized information in a computerized format. Qualitative interview responses supported that nurses felt that information was readily available and that computerized formats best fit into their normal workflow. However, problems with navigation of electronic systems and technology failure led to unmet information needs. The findings from this study support a considerable shift in the preferred and observed formats and sources of information utilized by nurses in clinical environments with fully integrated electronic medical records. In addition, data regarding the times of day that medical-surgical nurses most frequently search for certain types of information can inform the development of usable and needed clinical decision support.

Included in

Nursing Commons

Share

COinS