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Definition and Relational Specification of Work-around
Jennifer A Browne1, Carrie Jo Braden
1University of Texas Health Science Center, San Antonio, TX, United States.
Summary
Nursing work-arounds are often viewed negatively, but this study defines them within a complex adaptive system. Understanding work-arounds as mediators or moderators can improve Electronic Health Record integration and patient safety.
Area of Science:
- Nursing Informatics
- Complex Adaptive Systems Theory
Background:
- Nursing literature frequently discusses work-arounds, but the concept lacks clear definition and theoretical grounding.
- Existing assumptions often frame work-arounds negatively, necessitating elimination rather than understanding.
Purpose of the Study:
- To define nursing work-arounds within a complex adaptive system framework.
- To differentiate work-arounds as mediators versus moderators to enhance conceptual rigor in Nursing Informatics research.
Main Methods:
- Conceptual analysis of nursing work-arounds.
- Application of complex adaptive systems theory to categorize work-arounds.
Main Results:
- Work-arounds are defined with their full range of variation, viewed through mediator and moderator perspectives.
- Distinguishing between moderating variables (situation-bound, resistant to intervention) and mediating work-arounds (problem-solving for routine exceptions) is crucial.
Conclusions:
- A clearer conceptualization of nursing work-arounds is essential for advancing Nursing Informatics.
- This framework can inform Electronic Health Record integration, safety, quality, and efficiency initiatives.
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