Jennifer Sledge

Mapping the Nursing Process A New Approach for Understanding the Work of Nursing

The work of nursing is nonlinear and involves complex reasoning and clinical decision making. The use of human factors engineering (HFE) as a sole means for analyzing the work of nursing is problematic. Combining HFE analysis with qualitative observation has created a new methodology for mapping the nursing process. A cognitive pathway offers a new perspective for understanding the work of nursing and analyzing how disruptions to the nursing process may contribute to errors in the acute care environment.

Human Factors in Healthcare: Combining Quantitative and Qualitative Analysis

The increasing physical, emotional and cognitive demands placed on nurses and other health care workers, coupled with higher patient acuity levels in the healthcare settings, have increased the risks of employee work stress and potential errors. Large-scale re-engineering efforts to contain costs through staff reduction and streamlining of processes over the past two decades have contributed seemingly to increased job stress of healthcare workers. Traditional human factors engineering methods used to evaluate activities yield a linear listing of activities, time, and motions involved in the patient care process. However, this approach does not provide an understanding of the cognitive work of clinical decision-making. Without this understanding, it is impossible to make judgements on “value added” or wasted motions, and errors. Traditional Human Factors methodology can be enhanced by adding qualitative observation of the nursing care process. The combined methodology provides detailed documentation of environmental conditions, sources of interruptions, and cognitive demands which may contribute to medical errors and compromised quality of care.