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Evaluating a handheld decision support device in pediatric intensive care settings
Tera L Reynolds1, Patricia R DeLucia2, Karen A Esquibel3
1Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California, Irvine, Irvine, California, USA.
JAMIA Open
|January 28, 2020
Summary
Nurses desired a handheld decision support tool (pac2) for medication calculations in pediatric intensive care units, but limited use and no significant impact on cognitive load or errors were observed due to environmental and usability barriers.
Area of Science:
- Pediatric critical care medicine
- Health informatics
- Nursing technology adoption
Background:
- Handheld decision support devices aim to improve medication safety in intensive care.
- The pac2 technology was developed to aid nurses in complex bedside medication calculations.
Purpose of the Study:
- To evaluate end-user acceptance of the pac2 device among nurses in pediatric intensive care settings.
- To assess the impact of pac2 on cognitive load and medication administration errors.
Main Methods:
- A mixed-methods study was conducted in pediatric and neonatal intensive care units.
- Data collection involved ethnographic observations, interviews, and surveys during pre- and postimplementation phases.
Main Results:
- Nurses expressed a desire for such tools, but pac2 usage was limited.
- Barriers included the critical care environment, nurses' risk perceptions, and technology usability.
- No significant differences in cognitive load or administration errors were found post-deployment.
Conclusions:
- The standalone pac2 device had limited effect due to low adoption.
- Future mobile decision support technologies require integration with existing IT infrastructure and user-centered design for successful implementation.
- Usability is critical for realizing the potential benefits of these technologies.
