Workflow interruption and nurses' mental workload in electronic health record tasks: An observational study.

Area of Science:

• Nursing Informatics
• Human-Computer Interaction
• Healthcare Systems Engineering

Background:

• Workflow interruptions are prevalent in healthcare settings.
• Electronic Health Record (EHR) tasks involve significant human-machine interaction for nurses.
• Limited research exists on the impact of interruptions on nurses' mental workload during EHR tasks.

Purpose of the Study:

• To investigate the effects of frequent interruptions on nurses' mental workload.
• To examine multilevel factors influencing nurses' performance in EHR tasks.
• To understand the relationship between interruptions, mental workload, and task performance in nursing.

Main Methods:

• A prospective observational study was conducted in a tertiary hospital.
• Nurses' EHR task interruptions, reactions, and performance (errors/near errors) were documented.
• Validated questionnaires measured mental workload, task difficulty, system usability, and professional factors; path analysis was employed.

Main Results:

• 2871 interruptions were recorded across 145 shift observations.
• Task time, task difficulty, and system usability directly impacted mental workload.
• Mental workload and professional title influenced task performance, with negative affect mediating this relationship.

Conclusions:

• Frequent nursing interruptions in EHR tasks elevate mental workload and can lead to adverse outcomes.
• Reducing interruptions and task time is crucial for mitigating negative consequences.
• Improving EHR system usability and nurse training can decrease mental workload and enhance performance.