The primary objective of this study is to explore how nurse experience influences the patterns of documenting in electronic medical records (EMR) in an intensive care unit (ICU). To understand the time and work patterns related to EMR documentation, the real-time measurement system data was used. This log data is a representation of actions taken by ICU nurses during EMR documentation. To analyze the ICU nurse’s workflow related to EMR documentation, a hierarchical task analysis (HTA) was conducted. Multiple HTA charts were used to identify different patterns of EMR documentation between more experienced nurses and less experienced nurses. The results revealed that the nurse’s experience had significant impacts on the frequency of updating the assessment result page and reviewing clinical results in EMR. The findings from this study will contribute to revealing unknown usability problems of EMR documentation process.

We also investigated the impact of interrupting nurses on mental workload in emergency departments by using a Natural Goals Operators Methods and Selection rules Language (NGOMSL) simulation model. The model advanced our understanding of how interrupting nurses influenced their mental workload. A time study was conducted to collect emergency nurses’ behaviors related to clinical activities at the Mayo Clinic in Minnesota. After that, the NGOMSL simulation model was developed based on the time study data. Compared to the non-interruption scenario, the result showed that the nurse’s mental workload was 2.04 times higher during patient care activities and 4.72 times higher during EMR charting in the interruption scenario. The simulation results indicated that the NGOMSL model could demonstrate the impact on mental workload caused by interruptions in emergency departments. The findings of this study will contribute to developing a new way to measure nursing mental workload caused by the interruptions.

Selected Publications

Guo, W., Kim, J. H., Smith, B., & Despins, L. (2019). How Nurse Experience Influences the Patterns of Electronic Medical Record Documentation in an Intensive Care Unit. Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 63(1), 708–712.

Kim, J. H., Parameshwara, N., Guo, W., & Pasupathy, K. S. (2019). The impact of interrupting nurses on mental workload in emergency departments. International Journal of Human–Computer Interaction, 35(3), 206-217.


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