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Vital sign documentation in electronic records: The development of workarounds.

Authors
  • Stevenson, Jean E1, 2
  • Israelsson, Johan3, 2
  • Nilsson, Gunilla2
  • Petersson, Goran2
  • Bath, Peter A4
  • 1 The University of Sheffield, UK; Linnaeus University, Sweden. , (Sweden)
  • 2 Linnaeus University, Sweden. , (Sweden)
  • 3 Kalmar County Hospital, Sweden. , (Sweden)
  • 4 The University of Sheffield, UK.
Type
Published Article
Journal
Health informatics journal
Publication Date
Jun 01, 2018
Volume
24
Issue
2
Pages
206–215
Identifiers
DOI: 10.1177/1460458216663024
PMID: 27542887
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Workarounds are commonplace in healthcare settings. An increase in the use of electronic health records has led to an escalation of workarounds as healthcare professionals cope with systems which are inadequate for their needs. Closely related to this, the documentation of vital signs in electronic health records has been problematic. The accuracy and completeness of vital sign documentation has a direct impact on the recognition of deterioration in a patient's condition. We examined workflow processes to identify workarounds related to vital signs in a 372-bed hospital in Sweden. In three clinical areas, a qualitative study was performed with data collected during observations and interviews and analysed through thematic content analysis. We identified paper workarounds in the form of handwritten notes and a total of eight pre-printed paper observation charts. Our results suggested that nurses created workarounds to allow a smooth workflow and ensure patients safety.

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