Prospective memory in the ICU: the effect of visual cues on task execution in a representative simulation

Abstract

Despite the potential dangers of clinical tasks being forgotten, few researchers have investigated prospective memory (PM) – the ability to remember to execute future tasks – in health-care contexts. Visual cues help people remember to execute intentions at the appropriate moment. Using an intensive care unit simulator, we investigated whether nurses' memory for future tasks improves when visual cues are present, and how nurses manage PM demands. Twenty-four nurses participated in a 40-minute scenario simulating the start of a morning shift. The scenario included eight PM tasks. The presence or absence of a visually conspicuous cue for each task was manipulated. The presence of a visual cue improved recall compared to no cue (64% vs. 50%, p = 0.03 one-tailed, η _p ² = 0.15). Nurses used deliberate reminders to manage their PM demands. PM in critical care might be supported by increasing the visibility of cues related to tasks.

Practitioner summary: Nurses must remember to execute multiple future tasks to ensure patient safety. We investigated the effect of visual cues on nurses' ability to remember future tasks. Experimental manipulation of cues in a representative intensive care unit simulation indicated that visual cues increase the likelihood that future tasks are executed.

Keywords:

• interruptions
• prospective memory
• simulation
• intensive care
• nursing

Acknowledgements

This paper was written while Tobias Grundgeiger held an Endeavour International Postgraduate Research Scholarship at The University of Queensland. This project is supported by the National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Patient Safety (NHMRC ID 264643). The Centre is funded by the Australian Council for Safety and Quality in Health Care, and is an NHMRC Centre of Research Excellence. The Safety and Quality Council is a joint initiative of the Australian, State and Territory Governments. Further support was provided to P.M. Sanderson and B. Venkatesh by an Australian Research Council Discovery Project (ARC DP0880920). The authors thank the ICU staff of the Princess Alexandra Hospital for supporting the research and Stephen Whitcher for assisting with the AV recording.

Notes

^1. Now at Institute for Human-Computer-Media, Julius-Maximilians-Universität Würzburg, Germany.

Additional information

Notes on contributors

T. Grundgeiger

1 1. Now at Institute for Human-Computer-Media, Julius-Maximilians-Universität Würzburg, Germany.