Understanding Nurses' Strategies to Handle (Un)wanted Nurse Calls: A Resilience Perspective

Area of Science:

• Nursing Informatics
• Resilience Engineering
• Human-Computer Interaction

Background:

• Nurse calls are critical communication tools in hospitals, acting as either wanted or unwanted interruptions.
• Understanding nurses' management of these calls is vital for optimizing hospital workflows and patient safety.

Purpose of the Study:

• To investigate nurses' strategies for managing wanted and unwanted nurse calls.
• To explore how a wireless nurse call system impacts these strategies and patient safety.
• To inform the design of computer support systems based on nurses' real-world practices.

Main Methods:

• A 4-year qualitative case study at a Norwegian university hospital.
• Data collection through observations, interviews, and workshops.
• Analysis using a combined inductive and deductive approach.

Main Results:

• Nurses employ four primary collaborative strategies to manage nurse calls based on situational context.
• The existing wireless nurse call system necessitates suboptimal workarounds, hindering nurses' ability to adapt.
• Nurses' adaptive adjustments are crucial for maintaining efficient and safe hospital operations.

Conclusions:

• Effective nurse call systems must support nurses' dynamic strategies and performance variability.
• Designing technology to align with 'work as done' enhances practice resilience and patient safety.
• A deeper understanding of work-as-done is essential for successful technology implementation in healthcare.