Workflow interruption and nurses’ mental workload in electronic health record tasks: An observational study

Shan, Yawei; Shang, Jing; Yan, Yan; Ye, Xuchun

doi:10.1186/s12912-023-01209-9

Cited by 14 publications

(5 citation statements)

References 54 publications

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“…The total time was calculated when the nurse created the patient profile in several small steps. Nurses’ EMR tasks are sometimes interrupted by other priority events, leading to task switching [ 17 ]. If a nurse was in the middle of entering the patient profile and left without saving it or logging out, the input time may have been overestimated.…”

Section: Methodsmentioning

confidence: 99%

Impact of an Electronic Medical Record–Connected Questionnaire on Efficient Nursing Documentation: Usability and Efficacy Study

Kodama,

Konishi,

Manabe

et al. 2023

JMIR Nursing

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Background Documentation tasks comprise a large percentage of nurses’ workloads. Nursing records were partially based on a report from the patient. However, it is not a verbatim transcription of the patient's complaints but a type of medical record. Therefore, to reduce the time spent on nursing documentation, it is necessary to assist in the appropriate conversion or citation of patient reports to professional records. However, few studies have been conducted on systems for capturing patient reports in electronic medical records. In addition, there have been no reports on whether such a system reduces the time spent on nursing documentation. Objective This study aims to develop a patient self-reporting system that appropriately converts data to nursing records and evaluate its effect on reducing the documenting burden for nurses. Methods An electronic medical record–connected questionnaire and a preadmission nursing questionnaire were administered. The questionnaire responses entered by the patients were quoted in the patient profile for inpatient assessment in the nursing system. To clarify its efficacy, this study examined whether the use of the electronic questionnaire system saved the nurses’ time entering the patient profile admitted between August and December 2022. It also surveyed the usability of the electronic questionnaire between April and December 2022. Results A total of 3111 (78%) patients reported that they answered the electronic medical questionnaire by themselves. Of them, 2715 (88%) felt it was easy to use and 2604 (85%) were willing to use it again. The electronic questionnaire was used in 1326 of 2425 admission cases (use group). The input time for the patient profile was significantly shorter in the use group than in the no-use group (P<.001). Stratified analyses showed that in the internal medicine wards and in patients with dependent activities of daily living, nurses took 13%-18% (1.3 to 2 minutes) less time to enter patient profiles within the use group (both P<.001), even though there was no difference in the amount of information. By contrast, in the surgical wards and in the patients with independent activities of daily living, there was no difference in the time to entry (P=.50 and P=.20, respectively), but there was a greater amount of information in the use group. Conclusions The study developed and implemented a system in which self-reported patient data were captured in the hospital information network and quoted in the nursing system. This system contributes to improving the efficiency of nurses’ task recordings.

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Section: Methodsmentioning

confidence: 99%

Impact of an Electronic Medical Record–Connected Questionnaire on Efficient Nursing Documentation: Usability and Efficacy Study

Kodama,

Konishi,

Manabe

et al. 2023

JMIR Nursing

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show abstract

“…For example, Shan et al explored the rationale for the effects on mental workload and performance after task interruptions. The results showed that the interruption of this task was prone to cause negative emotions 12 . Negative emotion plays a mediating role in the path between task performance and mental workload, which may lead to the increase of mental workload.…”

Section: Backgroundsmentioning

confidence: 95%

Assessing cognitive workloads of assembly workers during multi-task switching

Ren,

Zhou,

Chen

2023

Sci Rep

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Complex assembly tasks with multiple manual operations and steps often require rapid judgment and action under time pressure and cause most human-related errors. The task switching and action transitions are major sources of these errors. This study intends to implement an electroencephalography (EEG) approach to quantitatively evaluate the mental workload during task switching and transition. The time–frequency and spectrum analysis were utilized to compute and reflect the task demand between the intervals of individual tasks. This study developed an experiment to validate the proposed assessment approach and benchmark the results with the National Aeronautics and Space Administration task load index (NASA-TLX) subjective evaluation scale analysis. The results show that the average value of the power spectral densities (PSDs) of the gamma band signal of the AF4 channel and the beta band signal of Channel F3 show distinctive signal patterns among task stages and intervals. During the interval between the idling stage and the part selection stage, the peak of the PSD envelope increased from 18 to 27 Hz, suggesting advanced cognition increases the mental workload of the interval between different tasks. Therefore, the task switching period cannot be regarded as rest and need to be optimized with better task organization.

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“…Currently, most related studies have examined the negative aspects of interruptions [ 4 , 5 ]. Surgical counting interruptions may result in prolonged operating time, reduced risk detection capabilities, and increased mental workload [ 6 – 8 ]. Therefore, measures should be taken to respond to interruptions, which should be managed according to source, attributes, outcomes and responses.…”

Section: Introductionmentioning

confidence: 99%

Surgical counting interruptions in operating rooms

Lujun,

Yuan,

Wei

2024

BMC Nurs

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Background Operating rooms are complex working environments with high workloads and high levels of cognitive demand. The first surgical count which occurs during the chaotic preoperative stage and is considered a critical phase, is a routine task in ORs. Interruptions often occur during the first surgical count; however, little is known about the first surgical counting interruptions. This study aimed to observe and analyse the sources, outcomes, frequency of the first surgical counting interruptions and responses to interruptions. Methods A retrospective observational study was carried out to examine the occurrence of the first surgical counting interruptions between 1st August 2023 and 30th September 2023. The data were collected using the “Surgical Counting Interruption Event Form”, which was developed by the researchers specifically for this study. Results A total of 66 circulating nurses (CNs) and scrub nurses (SNs) were observed across 1015 surgeries, with 4927.8 min of surgical count. The mean duration of the first surgical count was 4.85 min, with a range of 1.03 min to 9.51 min. In addition, 697 interruptions were identified, with full-term interruptions occurring an average of 8.7 times per hour. The most frequent source of interruption during the first surgical counts was instruments (N = 144, 20.7%). The first surgical counting interruptions mostly affected the CN (336 times; 48.2%), followed by the ORNs (including CNs and SNs) (243 times; 34.9%) and the SN (118 times; 16.9%). Most of the outcomes of interruptions were negative, and the majority of the nurses responded immediately to interruptions. Conclusions The frequency of the first surgical counting interruption is high. Managers should develop interventions for interruptions based on different surgical specialties and different nursing roles.

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Workflow interruption and nurses’ mental workload in electronic health record tasks: An observational study

Cited by 14 publications

References 54 publications

Impact of an Electronic Medical Record–Connected Questionnaire on Efficient Nursing Documentation: Usability and Efficacy Study

Impact of an Electronic Medical Record–Connected Questionnaire on Efficient Nursing Documentation: Usability and Efficacy Study

Assessing cognitive workloads of assembly workers during multi-task switching

Surgical counting interruptions in operating rooms

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