Nurses’ information practice in municipal health care – a web-like landscape

Elisabeth Ostensen, Line K. Bragstad, Nicholas Hardiker, Ragnhild Helleso

Research output: Contribution to journalArticle

Abstract

Aim: To uncover the characteristics of nurses' information practice in municipal health care and to address how, when and why various pieces of information are produced, shared and managed. Background: Nursing documentation in the electronic patient record has repeatedly been found unsatisfactory. Little is known about how the information practice of nurses in municipal health care actually is borne out. In order to understand why nursing documentation continues to fail at living up to the expected requirements, a better understanding of nurses' information practice is needed. Design: A qualitative observational field study. The study complied with the Consolidated Criteria for Reporting Qualitative Research. Methods: Empirical data were collected in three Norwegian municipalities through participant observations and individual interviews with 17 registered nurses on regular day shifts. The data were analysed through thematic content analysis. Results: Nurses' information practice in municipal health care can be described as complex. The complexity is reflected in four themes that emerged from the data: (1) web of information sources, (2) knowing the patient and information redundancy, (3) asynchronous information practice and (4) compensatory workarounds. Conclusions: The complex and asynchronous nature of nurses' information practice affected both how and when information was produced, recorded and shared. When available systems lacked functions the nurses wanted, they created compensatory workarounds. Although electronic patient record was an important part of their information practice, nurses in long-term care often knew their patients well, which meant that a lot of information about the patients was in their heads, and that searching for information in the electronic patient record sometimes seemed redundant. Relevance to clinical practice: This study provides contextual knowledge that might be valuable (a) in the further development of information systems tailored to meet nurses' information needs and (b) when studying patient safety in relation to nurses' information practice.

Original languageEnglish
Pages (from-to)2706-2716
Number of pages11
JournalJournal of Clinical Nursing
Volume28
Issue number13-14
Early online date2 Apr 2019
DOIs
Publication statusPublished - 1 Jul 2019

Fingerprint

Nurses
Delivery of Health Care
Documentation
Nursing
Qualitative Research
Long-Term Care
Patient Safety
Information Systems
Observational Studies
Head
Interviews

Cite this

Ostensen, Elisabeth ; Bragstad, Line K. ; Hardiker, Nicholas ; Helleso, Ragnhild. / Nurses’ information practice in municipal health care – a web-like landscape. In: Journal of Clinical Nursing. 2019 ; Vol. 28, No. 13-14. pp. 2706-2716.
@article{a7bbfbc1cdab493a85de9490d90bd48e,
title = "Nurses’ information practice in municipal health care – a web-like landscape",
abstract = "Aim: To uncover the characteristics of nurses' information practice in municipal health care and to address how, when and why various pieces of information are produced, shared and managed. Background: Nursing documentation in the electronic patient record has repeatedly been found unsatisfactory. Little is known about how the information practice of nurses in municipal health care actually is borne out. In order to understand why nursing documentation continues to fail at living up to the expected requirements, a better understanding of nurses' information practice is needed. Design: A qualitative observational field study. The study complied with the Consolidated Criteria for Reporting Qualitative Research. Methods: Empirical data were collected in three Norwegian municipalities through participant observations and individual interviews with 17 registered nurses on regular day shifts. The data were analysed through thematic content analysis. Results: Nurses' information practice in municipal health care can be described as complex. The complexity is reflected in four themes that emerged from the data: (1) web of information sources, (2) knowing the patient and information redundancy, (3) asynchronous information practice and (4) compensatory workarounds. Conclusions: The complex and asynchronous nature of nurses' information practice affected both how and when information was produced, recorded and shared. When available systems lacked functions the nurses wanted, they created compensatory workarounds. Although electronic patient record was an important part of their information practice, nurses in long-term care often knew their patients well, which meant that a lot of information about the patients was in their heads, and that searching for information in the electronic patient record sometimes seemed redundant. Relevance to clinical practice: This study provides contextual knowledge that might be valuable (a) in the further development of information systems tailored to meet nurses' information needs and (b) when studying patient safety in relation to nurses' information practice.",
keywords = "nursing documentation, electronic patient records, information practice, patient safety, continuity of care",
author = "Elisabeth Ostensen and Bragstad, {Line K.} and Nicholas Hardiker and Ragnhild Helleso",
year = "2019",
month = "7",
day = "1",
doi = "10.1111/jocn.14873",
language = "English",
volume = "28",
pages = "2706--2716",
journal = "Journal of Clinical Nursing",
issn = "0962-1067",
publisher = "Wiley-Blackwell",
number = "13-14",

}

Nurses’ information practice in municipal health care – a web-like landscape. / Ostensen, Elisabeth; Bragstad, Line K.; Hardiker, Nicholas; Helleso, Ragnhild.

In: Journal of Clinical Nursing, Vol. 28, No. 13-14, 01.07.2019, p. 2706-2716.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Nurses’ information practice in municipal health care – a web-like landscape

AU - Ostensen, Elisabeth

AU - Bragstad, Line K.

AU - Hardiker, Nicholas

AU - Helleso, Ragnhild

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Aim: To uncover the characteristics of nurses' information practice in municipal health care and to address how, when and why various pieces of information are produced, shared and managed. Background: Nursing documentation in the electronic patient record has repeatedly been found unsatisfactory. Little is known about how the information practice of nurses in municipal health care actually is borne out. In order to understand why nursing documentation continues to fail at living up to the expected requirements, a better understanding of nurses' information practice is needed. Design: A qualitative observational field study. The study complied with the Consolidated Criteria for Reporting Qualitative Research. Methods: Empirical data were collected in three Norwegian municipalities through participant observations and individual interviews with 17 registered nurses on regular day shifts. The data were analysed through thematic content analysis. Results: Nurses' information practice in municipal health care can be described as complex. The complexity is reflected in four themes that emerged from the data: (1) web of information sources, (2) knowing the patient and information redundancy, (3) asynchronous information practice and (4) compensatory workarounds. Conclusions: The complex and asynchronous nature of nurses' information practice affected both how and when information was produced, recorded and shared. When available systems lacked functions the nurses wanted, they created compensatory workarounds. Although electronic patient record was an important part of their information practice, nurses in long-term care often knew their patients well, which meant that a lot of information about the patients was in their heads, and that searching for information in the electronic patient record sometimes seemed redundant. Relevance to clinical practice: This study provides contextual knowledge that might be valuable (a) in the further development of information systems tailored to meet nurses' information needs and (b) when studying patient safety in relation to nurses' information practice.

AB - Aim: To uncover the characteristics of nurses' information practice in municipal health care and to address how, when and why various pieces of information are produced, shared and managed. Background: Nursing documentation in the electronic patient record has repeatedly been found unsatisfactory. Little is known about how the information practice of nurses in municipal health care actually is borne out. In order to understand why nursing documentation continues to fail at living up to the expected requirements, a better understanding of nurses' information practice is needed. Design: A qualitative observational field study. The study complied with the Consolidated Criteria for Reporting Qualitative Research. Methods: Empirical data were collected in three Norwegian municipalities through participant observations and individual interviews with 17 registered nurses on regular day shifts. The data were analysed through thematic content analysis. Results: Nurses' information practice in municipal health care can be described as complex. The complexity is reflected in four themes that emerged from the data: (1) web of information sources, (2) knowing the patient and information redundancy, (3) asynchronous information practice and (4) compensatory workarounds. Conclusions: The complex and asynchronous nature of nurses' information practice affected both how and when information was produced, recorded and shared. When available systems lacked functions the nurses wanted, they created compensatory workarounds. Although electronic patient record was an important part of their information practice, nurses in long-term care often knew their patients well, which meant that a lot of information about the patients was in their heads, and that searching for information in the electronic patient record sometimes seemed redundant. Relevance to clinical practice: This study provides contextual knowledge that might be valuable (a) in the further development of information systems tailored to meet nurses' information needs and (b) when studying patient safety in relation to nurses' information practice.

KW - nursing documentation

KW - electronic patient records

KW - information practice

KW - patient safety

KW - continuity of care

UR - http://www.scopus.com/inward/record.url?scp=85064611535&partnerID=8YFLogxK

U2 - 10.1111/jocn.14873

DO - 10.1111/jocn.14873

M3 - Article

VL - 28

SP - 2706

EP - 2716

JO - Journal of Clinical Nursing

JF - Journal of Clinical Nursing

SN - 0962-1067

IS - 13-14

ER -