Potter Patricia, Wolf Laurie, Boxerman Stuart, Grayson Deborah, Sledge Jennifer, Dunagan Clay, Evanoff Bradley
PBJC Health Care, St. Louis (PP, LW, JS). Washington University School of Medicine, St. Louis (SB, DG)
Health care researchers agree that the acute care hospital environment is filled with numerous distractions. Within this environment, professional nurses make clinical judgments about their patients, whose conditions may change minute by minute. As a result, nurses constantly organize and reorganize the priorities and tasks of care to accommodate patients' fluctuating status. To date, little attention has been given to how interruptions in the workplace influence nurses' ability to anticipate and carry out the actions directed by their clinical judgment. This paper describes an ongoing research study aimed at exploring the effect of interruptions on the cognitive work of nursing. A methodology combining human factors techniques and qualitative observation of nurses in practice has produced a cognitive pathway. The pathway is a unique visual graphic that offers a perspective of the nature of nurses' work and the relationship interruptions and cognitive load may have on omissions and errors in care. The approach to analyzing the cognitive work of nurses has important implications for understanding the origins of medical errors.
医疗保健研究人员一致认为，急症护理医院环境中存在众多干扰因素。在这种环境下，专业护士要对患者做出临床判断，而患者的病情可能每分钟都在变化。因此，护士需要不断地组织和重新安排护理的优先事项和任务，以适应患者不断变化的状况。迄今为止，很少有人关注工作场所的干扰如何影响护士预测和执行临床判断所指示行动的能力。本文描述了一项正在进行的研究，旨在探讨干扰对护理认知工作的影响。一种将人因工程技术与对护士实际工作的定性观察相结合的方法产生了一条认知路径。这条路径是一种独特的视觉图形，它展示了护士工作的性质，以及干扰和认知负荷可能对护理中的疏忽和错误产生的关系。分析护士认知工作的方法对于理解医疗差错的根源具有重要意义。
