The effects of clinical information presentation on physicians' and nurses' decision-making in ICUs

This research evaluated physicians' agreement about patients' diagnoses and nurses' ability to detect patient change using traditional charts (TC) and a work domain analysis-based paper prototype (PP) and also sought to determine whether differences persisted when the PP was represented as an electronic prototype (EP). Nurses' change detection improved using the PP and EP compared to TC (PP vs TC, t((df=6))=1.94, p<0.03; EP vs TC, t((df=6))=3.14, p<0.01) and detection was better using the EP compared with the PP (t((df=6))=5.96, p<0.001). Physicians were more likely to agree about failed physiological systems using the EP compared with the PP (t((df=10))=3.14, p<0.01), but agreement about patient diagnoses was higher using the PP compared with the EP (t((df=10))=2.23; p<0.02). These results are attributed to information grouping around physiological functions and the direct association of cause-and-effect relations in clinical information design.