Clinical Information Use by Medical and Nursing Staff in the ICU: Outcomes of a Coded Tables Analysis

Abstract

The long-term, intensive nature of patient admission to an Intensive Care Unit necessitates passing responsibilities from one medical and nursing staff member to another. An ideal outcome of this process is a common team situation awareness of the patient's condition. However, medical and nursing staff have different training and practice regimes, which raise questions about the nature of the situation awareness needed by the two groups. Statistical and an exploratory data analysis techniques were used to explore the information content of video-cued recall interviews in order to identify differences in information use. Doctors were found to attend to future patient projections over a broader range of physiological functions than nurses, reflecting a strategic orientation, whereas, nurses attended to sensed information over shorter timeframes than doctors, reflecting a tactical orientation. When not aligned these orientations may lead to breakdown in coordination and discontinuities in patient care.