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The Electronic Health Record's Impact on Labor and Delivery Nurses' Cognitive Work
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| 자료유형 | 학위논문 |
|---|---|
| 서명/저자사항 | The Electronic Health Record's Impact on Labor and Delivery Nurses' Cognitive Work. |
| 개인저자 | Wisner, Kirsten. |
| 단체저자명 | University of California, San Francisco. Nursing. |
| 발행사항 | [S.l.]: University of California, San Francisco., 2019. |
| 발행사항 | Ann Arbor: ProQuest Dissertations & Theses, 2019. |
| 형태사항 | 184 p. |
| 기본자료 저록 | Dissertations Abstracts International 81-05A. Dissertation Abstract International |
| ISBN | 9781088383735 |
| 학위논문주기 | Thesis (Ph.D.)--University of California, San Francisco, 2019. |
| 일반주기 |
Source: Dissertations Abstracts International, Volume: 81-05, Section: A.
Advisor: Lyndon, Audrey. |
| 이용제한사항 | This item must not be sold to any third party vendors. |
| 요약 | Background and objective: Despite recognition that electronic health record (EHR) use has introduced cognitive challenges for clinicians, few studies have evaluated its impact on the cognitive dimension of nurses' work. Labor and delivery nurses may encounter unique challenges when using the electronic health record since they also interact with an electronic fetal monitoring system. This study sought to explore labor and delivery nurses' perceptions of the EHR's impact on their cognitive work with the goal of identifying patient safety implications.Methods and setting: This was a grounded theory study using dimensional and situational analysis. Data were interviews and observations with 21 labor nurses at two community hospitals in the Western United States.Results: The ways that nurses configured care when using the EHR varied across participants and sites and depended on how easily they integrated it into their practice. Individual, group, and situational factors facilitated or constrained integration. This took place in a dynamic, high-acuity, specialty clinical environment while using EHRs that were not designed for pregnant women. Nurses used clinical decision support and other cognitive support features that rarely worked as intended due to the lack of EHR customization to account for pregnancy physiology and unique risk factors in the perinatal patient. Nurses viewed the quality of their relationships with patients and their families as an integral part of caring for laboring women and felt that interaction with the EHR sometimes threatened this dimension of their work.Conclusions: When nurses were unable to integrate the EHR into care it resulted in numerous consequences that have important safety implications. Available cognitive support features lacked the specialty-specific support needed to care for laboring women and instead required nurses to track information in other ways that added to their cognitive burden and work routines. As a result, nurses and patients were not benefitting from the intended decision support and patient safety protections offered by appropriate risk assessment screens or critical alerts. These findings have important implications for the configuration and design of EHRs in perinatal settings. |
| 일반주제명 | Nursing. Information technology. Obstetrics. Medical personnel. Public health. Health sciences. Mental health. Psychobiology. Physiological psychology. Cognitive psychology. |
| 언어 | 영어 |
| 바로가기 | 
: 이 자료의 원문은 한국교육학술정보원에서 제공합니다. |
