Potter Patricia, Wolf Laurie, Boxerman Stuart, Grayson Deborah, Sledge Jennifer, Dunagan Clay, Evanoff Bradley
Professional Practice, Barnes-Jewish Hospital, St. Louis, MO 63141, USA.
J Nurs Adm. 2005 Jul-Aug;35(7-8):327-35.
To combine human factors engineering techniques with qualitative observation of nurses in practice to analyze the nature of nurses' cognitive work and how environmental factors create disruptions that pose risks for medical errors.
Few researchers have examined the nature of nurses' cognitive work while in practice with patients. Researchers have described the broad range of thinking processes required in the acute care work setting, but have failed to examine how such processes are conducted and influenced by the complex care environment. A combined research methodology enables researchers to better understand how the nursing process becomes disrupted and the potential influence of this disruption on the safe and effective care of patients.
An ethnographic study, using mixed-methodological approaches, involved 7 staff registered nurses. The quantitative and qualitative data collection included field observation and summarative interviews.
A high number of cognitive shifts and interruptions, and a nurse's cumulative cognitive load, create the potential for disrupting a nurse's attention focus during care of patients. A majority of interruptions occurred as nurses performed interventions, particularly medication preparation.
New attention must be given to how care systems and work processes complement or interfere with nurses' cognitive work.
将人因工程技术与护士实际工作中的定性观察相结合，分析护士认知工作的本质，以及环境因素如何造成干扰并带来医疗差错风险。
很少有研究人员在护士与患者实际接触的过程中考察其认知工作的本质。研究人员描述了急性护理工作环境中所需的广泛思维过程，但未能考察这些过程是如何进行的，以及受复杂护理环境的何种影响。一种综合研究方法能使研究人员更好地理解护理过程是如何被扰乱的，以及这种扰乱对患者安全有效护理的潜在影响。
一项采用混合方法的人种学研究，涉及7名注册护士。定量和定性数据收集包括实地观察和总结性访谈。
大量的认知转换和干扰，以及护士累积的认知负荷，有可能在护理患者期间干扰护士的注意力焦点。大多数干扰发生在护士进行干预措施时，尤其是在准备药物期间。
必须重新关注护理系统和工作流程如何补充或干扰护士的认知工作。
