Clinical Barriers to Hands-Free, Eyes-Free Voice Input for Nursing Records: Field Usability Study

Area of Science:

• Nursing Informatics
• Clinical Documentation Technology
• Human-Computer Interaction

Background:

• Nursing documentation is vital for patient care quality but increases nurse workload and burnout.
• Voice input technology offers hands-free, eyes-free documentation, enabling simultaneous patient care and record entry.
• Limited adoption of voice input in nursing stems from privacy, technical, and usability concerns, with few studies exploring real-world concurrent documentation.

Purpose of the Study:

• To explore the feasibility of hands-free, eyes-free voice input for concurrent nursing documentation.
• To assess voice input usability in the structured environment of a catheterization laboratory.

Main Methods:

• A pilot study using a mixed methods exploratory design at Kyoto University Hospital.
• Five nurses used a prototype voice dialogue system alongside traditional records for eight procedures.
• Data collected via voice log comparison, usability surveys, and semistructured interviews.

Main Results:

• Voice input successfully captured 40%-100% of preoperative and intraoperative events, but only 0%-12% of postoperative events.
• The postoperative phase's high cognitive demands hindered voice documentation.
• Barriers included technical instability, "social awkwardness," and concerns about patient privacy and communication disruption.

Conclusions:

• Concurrent voice input faces significant barriers in clinical settings: system instability and conflict with care's social dynamics.
• Future implementations need visible devices, whisper recognition, and code words for sensitive data.
• Gradual implementation and large-scale studies are recommended to validate strategies for routine nursing documentation.