DUKE/UNC Joint Health Informatics Seminar Series
Title: Information Needed for the Care of Hospitalized Patients
Presenter: Tiffany Kelley, Ph.D., MBA, RN
The use of electronic nursing documentation is expected to improve the quality of care provided to hospitalized patients. However, the literature to support the use of electronic nursing documentation on the quality of care delivered to patients is limited to date. Additionally, limited knowledge exists describing the patterns of information use with paper-based nursing documentation. This presentation briefly describes the current literature and then discusses the need for preliminary studies before being able to compare paper with electronic nursing documentation. Next, the presentation will discuss the investigation of knowledge needed for nurses to know their patients. The information needs of nurses were categorized and an observational tool was created to measure nurses information needs. From the findings of the preliminary work, a mixed-methods multiple case study design was conducted on two units through two data collection phases while both units used paper-based (phase I) and subsequently electronic nursing documentation (phase II). Multiple methods of data collection were used to collect quantitative and qualitative data. Findings from the study revealed nurses collected, communicated and temporarily stored all 17 categories of nurses’ information needs across available verbal, paper, and electronic information sources. Multiple information sources were used to collect the information needed for care. Yet, the sources varied depending on the period of the nurse’s workday. There were more similarities than differences between the two cases on the collection, communication and storage of information needs. The major differences were found with the use of electronic nursing documentation in comparison to paper-based nursing documentation. New processes of collecting, communicating and temporarily storing information needs were introduced with the use of electronic nursing documentation. Future studies should investigate the effects of the use of electronic nursing documentation to collect and communicate information needed for care on the efficiency, timeliness and safety of care.
Dr. Kelley is a recent graduate of Duke University School of Nursing’s Ph.D. Program. Her dissertation focused on understanding the use of information by nurses and health care team members while using paper and then electronic nursing documentation sources. From this research, she aims to provide recommendations toward electronic nursing documentation standards as well as identify ways in which electronic health records (EHRs) can be optimized for safe delivery of care. Before coming to Duke to pursue her Ph.D., Dr. Kelley spent 3 years working on a large-scale team to implement a comprehensive pediatric electronic medical record at Children’s Hospital of Boston. Dr. Kelley holds a Master of Science in Nursing Administration and MBA from Northeastern University. She received her Bachelor of Science in Nursing from Georgetown University.