An Observational Investigation of On-Duty Critical Care Nurses' Information Behavior in a Nonteaching Community Hospital

Published on May 1, 2004
Michelynn McKnight1
Estimated H-index: 1
Critical care nurses work in an environment rich in informative interactions. Although there have been post hoc self-report survey studies of nurses' information seeking, there have been no observational studies of the patterns and content of their on-duty information behavior. This study used participant observation and in-context interviews to describe 50 hours of the observable information behavior of a representative sample of critical care nurses in a 20-bed critical care hospital unit. The researcher used open, in vivo, and axial coding to develop a grounded theory model of their consistent pattern of multimedia interactions. The resulting Nurse's Patient-Chart Cycle describes nurses' activities during the shift as centering on a regular alternation with the patient and the patient's chart (various record systems), clearly bounded with nursing "report" interactions at the beginning and the end of the shift. The nurses' demeanor markedly changed between interactions with the chart and interactions with the patient. Other informative interactions were observed with other health care workers and the patient's family, friends and visitors. The nurses' information seeking was centered on the patient. They mostly sought information from people, the patient record and other digital systems. They acted on or passed on most of the information they found. Some information they recorded for their personal use during the shift. The researcher observed the nurses using mostly patient specific information, but they also used some social and logistic information. They occasionally sought knowledge based information. Barriers to information acquisition included illegible handwriting, difficult navigation of online systems, equipment failure, unavailable people, social protocols and mistakes caused by multi-tasking people working with multiple complex systems. No formal use was observed of standardized nursing diagnoses, nursing interventions, or nursing outcomes taxonomies. While the nurses expressed respect for evidence-based practice, there clearly was no time or opportunity for reading research literature (either on paper or online) while on duty. All participants expressed frustration with the amount of redundant data entry required of them. The results of this study have significant implications for the design of clinical information systems and library services for working critical care nurses.
  • References (77)
  • Citations (3)
📖 Papers frequently viewed together
96 Citations
1 Citations
177 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
#1Donald O. CaseH-Index: 21
#2Lisa M. GivenH-Index: 18
Abbreviated Contents Figures and Tables Preface Introduction and Examples Concepts Relevant to Information Behavior Models, Paradigms, and Theories in the Study of Information Behavior Methods for Studying Information Behavior Research Results and Reflections Appendix: Glossary Appendix: Questions for Discussion and Application References Index
1,109 Citations
#1Inger Ekman (College of Health Sciences, Bahrain)H-Index: 42
#2Kerstin Segesten (University of Gothenburg)H-Index: 17
The exchange of oral shift reports between nurses is a prominent part of the everyday routine in a hospital ward Increased awareness of the more or less explicit functions of such communication is likely to have a positive impact on the nursing profession Oral shift reports in a nursing care system based on task allocation were therefore observed and analysed Using an ethnographic approach, reports were tape-recorded, and nurses were interviewed regarding their experiences During the shift repor...
87 CitationsSource
#1Martin Dawes (McGill University)H-Index: 34
#2Uchechukwu Sampson (Brigham and Women's Hospital)H-Index: 4
Objectives: To determine information seeking behavior of physicians. Data sources: Systematic review of 19 studies that described information seeking behavior in a number of different settings using differing methodologies. Analysis was limited to quantitative studies describing sources of information sought by physicians. Results: Investigators have used questionnaires, interviews and observation to identify the information seeking behavior of clinicians. The results were mainly obtained from t...
238 CitationsSource
8 CitationsSource
#3BsH-Index: 1
If done poorly, a verbal report wastes time and can even jeopardize patient safety. Here's how to give verbal reports quickly and accurately.
8 Citations
256 CitationsSource
Research questions in health sciences libraries are influenced by the health care environment. Three fundamental problems underlie most research in health sciences librarianship: determining what therapies are effective and of good quality, delivering information when and where it is needed, and in forms that will increase its use. Adapting to sweeping changes in all kinds of libraries is made more complex because of equally challenging shifts in medical practice and consumer health. Development...
11 Citations
#1Paul Crawford (University of Nottingham)H-Index: 22
#2Brian J. Brown (DMU: De Montfort University)H-Index: 23
Last. Carolyn Hicks (University of Birmingham)H-Index: 21
view all 4 authors...
The National Service Framework for Mental Health (1999) emphasizes the need for a culture of evidence-based practice (EBP) in mental health care. However, there is relatively little research addressing EBP from the perspective of community mental health nurses and we are still unsure of why the uptake of this style of working has been slow. This paper suggests that rather than thinking in terms of ‘barriers’ to the uptake of EBP, the issue may best be conceptualized as a form of praxis on the pa...
30 CitationsSource
Pharmacy could serve as a model for the health informationist profession proposed by Davidoff and Florance in their 2000 editorial in the Annals of Internal Medicine. The current training and practice roles for pharmacists suggest a way to prepare health sciences librarians for work with clinical health care teams. The influences that spurred the transformation of pharmacy parallel in many respects those suggesting the need for more information professionals prepared to practice in clinical heal...
29 Citations
#1Cathy M. PerleyH-Index: 1
3 Citations
Cited By3
#1Michelynn McKnight (LSU: Louisiana State University)H-Index: 5
Purpose – Critical care nurses' work is rich in informative interactions. Although there have been post‐hoc self report studies of nurses' information seeking, there have been no observational studies of the patterns of their on‐duty information behavior. This paper seeks to address this issue.Design/methodology/approach – This study used participant observation and in context interviews to describe 50 hours of the observable information behavior of a representative sample of critical care nurse...
32 CitationsSource
Introduction: This project is a collaborative effort of the Task Force on Mapping the Nursing Literature of the Nursing and Allied Health Resources Section of the Medical Library Association. This overview summarizes eighteen studies covering general nursing and sixteen specialties. Method: Following a common protocol, citations from source journals were analyzed for a three-year period within the years 1996 to 2000. Analysis included cited formats, age, and ranking of the frequency of cited jou...
52 Citations