Developing Theoretical Underpinnings for Nursing Workaround Research Using a Mixed Method Approach

Area of Science:

• Nursing Informatics
• Health Information Technology
• Healthcare Workflow Analysis

Background:

• The implementation of health information technology (HIT) in acute care settings has presented unforeseen challenges to established nursing workflows.
• Automation of documentation and medication administration via HIT has, in some cases, led to increased time and steps for nurses to complete tasks.
• These workflow disruptions have prompted nurses to develop adaptive strategies, known as workarounds, to maintain efficiency and patient care.

Purpose of the Study:

• To address the lack of standardized definitions and research models for nursing workarounds related to HIT.
• To propose clear definitions for workarounds and identify associated variables.
• To present a multi-level model for understanding and researching HIT-related workarounds in nursing.

Main Methods:

• A mixed-methods study was employed to investigate nursing workarounds.
• Data collection likely involved qualitative and quantitative approaches to capture the complexity of the phenomenon.
• Analysis focused on defining workarounds, identifying key variables, and developing a conceptual model.

Main Results:

• The study successfully proposed definitions for nursing workarounds in the context of HIT.
• Associated variables influencing or resulting from workarounds were identified.
• A novel multi-level model was developed to structure future research in this area.

Conclusions:

• Standardized definitions and a conceptual model are crucial for advancing research on nursing workarounds.
• Understanding workarounds is essential for optimizing HIT implementation and mitigating negative impacts on nursing workflow.
• This work provides a foundation for future studies aimed at improving HIT usability and effectiveness in acute care.