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Research Article

Behavioral signs of an unintended error in nursing information sharing with electronic clinical pathways: a mixed research approach

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ABSTRACT

Electronic clinical pathways (ECPs) strongly encourage the standardization of medical treatment and the sharing of information among medical staff. The goal of this study was to determine the influence of ECPs on information sharing among nurses in a university hospital. Four experienced nurses, selected based on ECP composing and operation experience, were recruited from the department with the most frequent users in the first-round interview, 132 nurses’ questionnaire answers were analyzed, and eight nurses participated in the second-round interview. This study conducted a mixed-method (interview–questionnaire–interview) investigation to extract the behavioral signs of unintended errors in information sharing after the ethical approval was obtained. On the basis of ANOVA and t-test for the questionnaire and constant comparison for interview, this study found that the greater extent of user dependency on convenient ECPs in the frequent-use group led to mistakes under hectic conditions. This study also found evidence of poor management of ECPs when problems occurred. The immature design of ECPs provoked inappropriate behaviors among nurses even though they brought about some benefits such as mitigation of the burden of daily recording tasks. The findings empirically showed the ECP user’s behavioral changes regarding the technology-induced error.

Acknowledgments

The authors thank Ms Hiroko Ogawa for her advice regarding the questionnaire and our participants for their efforts and time. This study was partially supported by the Grant-in-Aid for Scientific Research (No. 26502008, 15K16168, 17KT0084) from the Japan Society for the Promotion of Science.

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