1.3.3 Enabling continuity of care: The role of nurses in ensuring informational continuity (403)
Rebecca Randell, Researcher in Human-Computer Interaction, Centre for HCI Design, City University, London, United Kingdom Co authors: Peter Woodward, Stephanie Wilson & Julia Galliers rebecca.randell.1@city.ac.uk
Abstract:
Background:
Continuity of care has been an enduring concern within healthcare and effective handover is seen as a key tool in ensuring informational continuity. The question of how to get handover ‘right’ is of escalating importance with shorter working hours for doctors and an increase in shift patterns of working. These changes mean more frequent handovers and greater cross-coverage. As part of a larger project to develop technology to support handover, we are conducting studies of handover in a range of hospital settings. Initial analysis of the data so far collected suggests that nurses play an important role in ensuring informational continuity amongst medical staff, as well as in determining when involvement of medical staff is required.Objective:
To explore how nurses contribute to ensuring continuity of care in hospital settings.
Methods:
A multiple case study design is being used. Case sites have been purposively selected to ensure that there is adequate variation in size of the ward, medical complexities and severities, and demographic diversity of patient populations. At each case site, a range of handovers will be observed, in addition to at least 90 hours of ethnographic observation of the setting and informal interviews with a range of clinicians. Data collection has been completed in an emergency assessment unit, a general medical ward, and a paediatric surgical ward. It is intended that data collection will be conducted in a further seven settings. The data will be analysed using thematic content analysis.
Results:
We will present the analysis of the collected data, focusing on how nurses contribute to ensuring informational continuity amongst medical staff and how nurses determine when involvement of medical staff is required. The implications of the analysis will be discussed and promising areas for future research will be highlighted.
Biography:
Rebecca joined the Centre for HCI Design in January 2007. She has a PhD in Human-Computer Interaction from the University of Glasgow and a BSc Hons in Software Engineering from the University of Durham. Her research focuses on the design and evaluation of technology within healthcare, through the use of qualitative research methods. Her PhD explored how nurses appropriate and customise the technology within the intensive care unit. Prior to coming to City, Rebecca worked on a Department of Health funded project in the Department of Health Science at the University of York, exploring nurses' use of computerised decision support systems. At present, Rebecca is working on the GHandI project, which aims to design innovative technologies to support medical handover.