Search

Abstract Background Workflow interruptions are common in modern work systems. Electronic health record (EHR) tasks are typical tasks involving human–machine interactions in nursing care, but few studies have examined interruptions and nurses’ mental workload in the tasks. Therefore, this study aims to investigate how frequent interruptions and multilevel factors affect nurses’ mental workload and performance in EHR tasks. Methods A prospective observational study was conducted in a tertiary hospital providing specialist and sub-specialist care from June 1st to October 31st, 2021. An observer documented nurses’ EHR task interruptions, reactions and performance (errors and near errors) during one-shift observation sessions. Questionnaires were administered at the end of the electronic health record task observation to measure nurses’ mental workload for the electronic health record tasks, task difficulty, system usability, professional experience, professional competency, and self-efficacy. Path analysis was used to test a hypothetical model. Results In 145 shift observations, 2871 interruptions occurred, and the mean task duration was 84.69 (SD 56.68) minutes per shift. The incidence of error or near error was 158, while 68.35% of errors were self-corrected. The total mean mental workload level was 44.57 (SD 14.08). A path analysis model with adequate fit indices is presented. There was a relationship among concurrent multitasking, task switching and task time. Task time, task difficulty and system usability had direct effects on mental workload. Task performance was influenced by mental workload and professional title. Negative affect mediated the path from task performance to mental workload. Conclusions Nursing interruptions occur frequently in EHR tasks, come from different sources and may lead to elevated mental workload and negative outcomes. By exploring the variables related to mental workload and performance, we offer a new perspective on quality improvement strategies. Reducing harmful interruptions to decrease task time can avoid negative outcomes. Training nurses to cope with interruptions and improve competency in EHR implementation and task operation has the potential to decrease nurses’ mental workload and improve task performance. Moreover, improving system usability is beneficial to nurses to mitigate mental workload.

Background: Workflow interruptions are common in modern work systems. Electronic health record (EHR) tasks are typical tasks involving human–machine interactions in nursing care, but few studies have examined interruptions and nurses' mental workload in the tasks. Therefore, this study aims to investigate how frequent interruptions and multilevel factors affect nurses' mental workload and performance in EHR tasks. Methods: A prospective observational study was conducted in a tertiary hospital providing specialist and sub-specialist care from June 1st to October 31st, 2021. An observer documented nurses' EHR task interruptions, reactions and performance (errors and near errors) during one-shift observation sessions. Questionnaires were administered at the end of the electronic health record task observation to measure nurses' mental workload for the electronic health record tasks, task difficulty, system usability, professional experience, professional competency, and self-efficacy. Path analysis was used to test a hypothetical model. Results: In 145 shift observations, 2871 interruptions occurred, and the mean task duration was 84.69 (SD 56.68) minutes per shift. The incidence of error or near error was 158, while 68.35% of errors were self-corrected. The total mean mental workload level was 44.57 (SD 14.08). A path analysis model with adequate fit indices is presented. There was a relationship among concurrent multitasking, task switching and task time. Task time, task difficulty and system usability had direct effects on mental workload. Task performance was influenced by mental workload and professional title. Negative affect mediated the path from task performance to mental workload. Conclusions: Nursing interruptions occur frequently in EHR tasks, come from different sources and may lead to elevated mental workload and negative outcomes. By exploring the variables related to mental workload and performance, we offer a new perspective on quality improvement strategies. Reducing harmful interruptions to decrease task time can avoid negative outcomes. Training nurses to cope with interruptions and improve competency in EHR implementation and task operation has the potential to decrease nurses' mental workload and improve task performance. Moreover, improving system usability is beneficial to nurses to mitigate mental workload. [ABSTRACT FROM AUTHOR]

Wen-Guang Zhang,1 Jia-Wei Liu,2 Su-Yun Yang,3 Qiao-Qian Wang,4 Chen-Xing Liu,2 Yao Li2 1Department of Nursing, The First Hospital of Shanxi Medical University, Taiyuan, 030000, People’s Republic of China; 2School of Nursing, Shanxi Medical University, Taiyuan, 030000, People’s Republic of China; 3Department of Nuclear Medicine, The First Hospital of Shanxi Medical University, Taiyuan, 030000, People’s Republic of China; 4Department of Hypertension, The First Hospital of Shanxi Medical University, Taiyuan, 030000, People’s Republic of ChinaCorrespondence: Su-Yun YangDepartment of Nuclear Medicine, The First Hospital of Shanxi Medical University, Room 601, Unit 8, Building 1, No. 8 Wenyuan Lane, Yingze District, Taiyuan, 030000, People’s Republic of ChinaTel +8613603512029Email syy_dr09sun@163.comObjective: This study aimed to evaluate the effect of closed-loop management on nursing disruption risk.Methods: Using a quasi-experimental research method, convenient sampling was used to extract 20 nurses working at our hospital as the research objects. The control group members were selected from January to March 2018 via the traditional method, and the experimental group members were selected from April to June 2018 via the closed-loop management method. At three months before and after the implementation of the management model, a self-designed quantitative test form and satisfaction questionnaire were used to analyze the frequency of nursing disruption events, the accuracy rate of doctors’ advice, the average drug delivery time of the static distribution center, the implementation rate of personal digital assistant (PDA) code scanning, and the report rate of risk-outcome nursing disruption events.Results: After the implementation of the management model, the frequency of nursing disruptions and average drug delivery time of the static distribution center were significantly lower than before, and the differences were statistically significant (p < 0.05). Moreover, the accuracy rate of doctors’ advice, the implementation rate of PDA code scanning, and the reporting rate of risk-outcome nursing disruption events were significantly higher than before, and these differences were statistically significant as well (p < 0.05).Conclusion: The application of a closed-loop management model could significantly reduce the occurrence and optimize the outcomes of nursing disruption events and improve the work processes of medical care.Keywords: closed-loop management, nursing interruption, risk control, personal digital assistant, PDA, management mode

Aim: To analyse the frequency and core elements of nursing work interruptions in Chinese emergency nursing settings. Background: Little is known about nursing interruptions, which affect the quality of services in Chinese emergency nursing setting. Method(s): A cross‐sectional observational study was conducted in three units of an emergency department in a Chinese tertiary hospital. Participants comprised 60 nurses. Data were collected using a questionnaire developed by the researchers specifically for this study. Results: In total, 25,965 min of work was observed and 2333 interruptions were identified. Most interruptions were from patients, their families and nurses. Therapeutic nursing and patient observation and documentation were the most frequently interrupted procedures. Most interruptions were negative, and a majority of the nurses immediately responded to interruptions. Significant differences existed in the overall distribution of the core elements among the three nursing units. Conclusions: The frequency of emergency nursing interruptions was moderate. Most interruptions tend to lead to negative treatment outcomes for patients. Implications for Nursing Management: Emergency nursing managers should recognize the importance of interruptions, understand work situations better and develop ways to reduce the incidence of interruptions. Thus, nursing risks can be avoided by reducing the adverse outcomes caused by work interruptions. [ABSTRACT FROM AUTHOR]