One Size Does Not Fit All: EHR Clinical Summary Design Requirements for Nurses.

Research has established the pivotal role of cognitive artifacts to human information visualization, the reduction of memory load, and critical thinking. A long-standing nursing practice is the development of a personal cognitive artifact that summarizes the clinical condition and plan of care for the patient(s) in the care of the nurse. Distributed cognition establishes the importance of the role of cognitive artifacts to the cognition of each individual.

Informaticians: how they may benefit your healthcare organization.

The heightened focus on health information technology deployment, specifically the electronic health record, has magnified the need for the knowledge and skills of informaticians. The clinical informatician is frequently confused with system analyst and project management roles. In this article, the authors explore the knowledge and skills of informaticians and how to determine the skill combinations most suited to an organization and compare the roles of informaticians, project managers, and information technology professionals.

Concept analysis of cognitive artifacts.

Cognitive artifacts--information displays that inform thought processes and increase knowledge--fulfill a fundamental role in distributed cognition. Cognitive work--the mental processes of selecting and evaluating data, reasoning, and making decisions--is guided and informed by cognitive artifacts, especially in clinical areas. The importance of cognitive artifacts to cognitive work suggests the need to study and comprehensively understand cognitive artifacts prepared and used by the clinical nurses and how these documents influence and guide nursing practice.

When your words count: a discriminative model to predict approval of referrals.

Objective: To develop and test a statistical model which correctly predicts the approval of outpatient referrals when reviewed by a specialty service based on nine discriminating variables.

Design: Retrospective cross-sectional study.

Setting: Large public county hospital system in a southern US city.

Developing a taxonomy and an ontology of nurses' patient clinical summaries.

Nurses prepare a summary of patient information that they consult and update throughout the shift. This document is believed to be integral to cognition, working memory, and decision-making. While serving as a key support to nursing practice, this summary also represents risks to patient safety.

Taxonomy development and knowledge representation of nurses' personal cognitive artifacts.

Nurses prepare knowledge representations, or summaries of patient clinical data, each shift. These knowledge representations serve multiple purposes, including support of working memory, workload organization and prioritization, critical thinking, and reflection. This summary is integral to internal knowledge representations, working memory, and decision-making.

Application of cognitive engineering principles to the redesign of a dichotomous identification key for parasitology.

Dichotomous identification keys are used throughout biology for identification of plants, insects, and parasites. However, correct use of identification keys can be difficult as they are not usually intended for novice users who may not be familiar with the terminology used or with the morphology of the organism being identified. Therefore, we applied cognitive engineering principles to redesign a parasitology identification key for the Internet.

Creating EHR value for managers.

EHR systems provide benefit to practitioners, patient care, and research. These systems also offer information that support managers in assessment of clinical practice patterns, utilization of protocols, identification of quality improvement opportunities, and practice patterns of individuals and groups. Manager awareness and recognition of the value of the information contained in an EHR system influences the dissemination of related benefits and opportunities.

Designing an EMR planning process based on staff attitudes toward and opinions about computers in healthcare.

Electronic medical record (EMR) systems have been in use for more than 2 decades. Studies documenting nursing satisfaction with an EMR system, the benefits of an EMR, implementation barriers, user acceptance, the importance of staff buy-in, and the importance of attitudes toward and expectations from user buy-in are in the literature. Central to many studies is the importance of nursing staff buy-in to the successful implementation and ongoing use of an EMR, as well as the dependency of buy-in on staff attitudes and expectations.