Handsfree Communication Devices (HCDs) provide healthcare providers with an efficient way to communicate. However, they create new pathways for interruptions. The aim of this study is to understand how nurses use HCDs for interruptions from a systems perspective. Five Registered Nurses (RNs) in pediatric Intensive Care Units (ICU) were shadowed for a total of 15 hours. Fourteen interruptions mediated by HCDs were recorded and coded based on the identified themes. Results show that both interrupters and interruptees have to make decisions in the way of communicating with other people using HCDs. However, there is no standard way of making the choice, creating opportunities for medical errors. Based on this understanding, we propose several work system design recommendations at different levels.
Get full access to this article
View all access options for this article.
References
1.
AlvarezG.CoieraE. (2005). Interruptive communication patterns in the intensive care unit ward round. International Journal of Medical Informatics, 74(10), 791-796.
2.
AvrahamiD.GergleD.HudsonS. E.KieslerS. (2007). Improving the match between callers and receivers: A study on the effect of contextual information on cell phone interruptions. Behaviour & Information Technology, 26(3), 247-259.
3.
CarayonP.HundtA. S.KarshB.GursesA. P.AlvaradoC. J.SmithM.Flatley BrennanP. (2006). Work system design for patient safety: The SEIPS model. Quality & Safety in Health Care, 15(Suppl I), 50-58.
4.
ClarkH. H.BrennanS. E. (1991). Grounding in communication. In ResnickL.LevineJ.TeasleyS. (eds.). Perspectives on Socially shared cognition (pp. 127-149). Washington, DC: American Pyschological Association.
5.
CreswellJ. W. (2012). Qualitative Inquiry and Research Design: Choosing Among Five Approaches (3rd ed.). Thousand Oaks, CA: Sage Publications.
6.
DeversK. J. (1999). How will we know" good" qualitative research when we see it? Beginning the dialogue in health services research. Health Service Research Journal, 34(5 Part II), 1153-1188.
7.
ErnstA. A.WeissS. J.ReitsemaJ. A. (2013). Does the addition of Vocera hands-free communication device improve interruptions in an academic emergency department?Southern Medical Journal, 106(3), 189-195.
8.
FlynnE. A.BarkerK. N.GibsonJ. T.PearsonR. E.BergerB. A.SmithL. A. (1999). Impact of interruptions and distractions on dispensing errors in an ambulatory care pharmacy. American Journal of Health System Pharmacy, 56, 1319- 1325.
9.
GrandhiS. A.JonesQ. (2009). Conceptualizing interpersonal interruption management: a theoretical framework and research program. In Proceedings of the 42nd Hawaii International Conference on System Sciences. 1-10.
10.
GuptaA.ShardaR.DongY.ShardaR.AsamoahD.PickeringB. (2013). Improving rounding in critical care environments through management of interruptions. Decision Support Systems, 55(2), 516-527.
11.
HendrickH. W.KleinerB. M. (2001). Macroergonomics: An Introduction to Work System Design. Santa Monica, CA: Human Factors and Ergonomic Society.
12.
HoldenR. J.CarayonP.GursesA. P.HoonakkerP.HundtA. S.OzokA. A.Rivera-RodriguezA. J. (2013). SEIPS 2.0: A human factors framework for studying and improving the work of healthcare professionals and patients. Ergonomics, 56(11), 1669-1686.
13.
Institute of Medicine. (2000). To Err is Human: Building a Safer Health System. Washington, DC: National Academy Press.
14.
KochS. H.WeirC.HaarM.StaggersN.AgutterJ.GörgesM.WestenskowD. (2012). Intensive care unit nurses’ information needs and recommendations for integrated displays to improve nurses’ situation awareness. Journal of the American Medical Informatics Association, 19(4), 583-590.
15.
ManserT. (2009). Teamwork and patient safety in dynamic domains of healthcare: A review of the literature. Acta Anaesthesiologica Scandinavica, 53(2), 143-151.
16.
NewcombE. M. (2011). Critical Communication: Observing How ICU Environments Impact Nurse Communication (Master’s thesis). Arizona State University, Tempe, AZ.
17.
PattersonE. S.RogersM. L.ChapmanR. J.RenderM. L. (2006). Compliance with intended use of bar code medication administration in acute and long-term care: An observational study. Human Factors, 48(1), 15-22.
18.
Rivera-RodriguezA.KarshB. (2010). Interruptions and distractions in healthcare: Review and reappraisal. Quality and Safety in Health Care, 19(4), 304-312.
19.
RiveraA. J. (2014). A socio-technical systems approach to studying interruptions: Understanding the interrupter’s perspective. Applied Ergonomics, 45(3), 747-765.
20.
SandersonP. M.GrundgeigerT. (2015). How do interruptions affect clinician performance in healthcare? Negotiating fidelity, control, and potential generalizability in the search for answers. International Journal of Human-Computer Studies, 79, 85-96.
21.
SrinivasP.FaiolaA.MarkG. (2016, May). Designing Guidelines for Mobile Health Technology: Managing Notification Interruptions in the ICU. In Proceedings of the 2016 CHI Conference on Human Factors in Computing Systems (pp. 4502-4508). ACM.
22.
WestbrookJ. I.WoodsA.RobM. I.DunsmuirW.DayR. O. (2010). Association of interruptions with an increased risk and severity of medication administration errors. Archives of Internal Medicine, 170(8), 683-690.
23.
WiegmannD. A.ElBardissiA. W.DearaniJ. A.DalyR. C.SundtT. M. (2007). Disruptions in surgical flow and their relationship to surgical errors: an exploratory investigation. Surgery, 142(5), 658-665.
24.
WuR. C.TranK.LoV.O’LearyK. J.MorraD.QuanS. D.PerrierL. (2012). Effects of clinical communication interventions in hospitals: A systematic review of information and communication technology adoptions for improved communication between clinicians. International Journal of Medical Informatics, 81(11), 723-732.
25.
YangY.RiveraA. J. (2015). An observational study of hands-free communication devices mediated interruption dynamics in a nursing work system. Health Policy and Technology. 4(4), 378-386.
