10 things acute care nurses need to succeed

Allscripts User Experience team recently conducted a field study of 100 nurses at 10 hospitals. We wanted to better understand what problems and hindrances acute care nurses experienced and how technology can help nurses deliver better patient care.

The findings will help shape our solution development efforts, particularly in mobility. We shadowed nurses in a variety of departments and watched their interactions with other nurses, techs, physicians and patients, as well as all of the tools and technologies they use during their shift.

Acute care nurses have unique challenges

Our research shows that nurses have very different problems than physicians do. They are constantly being interrupted while trying to maintain and manage their conversations with other clinicians and patients.

Acute Care Nurses often still use paper, entering data into Allscripts Sunrise much later.

Most acute care nurses are documenting vitals and patient information twice, often using paper even when computer entry is available.

One finding we saw repeated in all hospitals was the nurse reliance on paper and the creation of paper “brains” to keep track of their tasks and for temporary note taking.

I make this hourly chart every morning [on paper], because I like to know what I need to do each hour of my shift. This ‘brain’, as I call it, is my safety net.”

They are recording tasks to complete, patient vitals, medications and other information on paper. They add the data into Sunrise later – often many hours later. Unfortunately, their to-do lists get out of date very quickly.


Acute care nurses are clear about what can help

Our team developed 10 themes that illustrate the most significant challenges acute care nurses face. These are also the most promising areas for development efforts. Put into the voice of a nurse, solution needs include:

1.    Don’t make me do the same thing multiple times.

2.    Combine patient information to give me only what I need, when I need it.

3.    Give a clear to-do list – that shows completed tasks — for each patient.

4.    Enable me to document quick tasks at the time of completion.

5.    Let me know when I have something to do wherever I am.

6.    Remind me what I was doing when I get interrupted (or when I  multi-task).

7.    Help me to communicate with less disruption with the right people.

8.    Give peace of mind that my part of the task workflow is complete.

9.    Show the physical location of my patients (and staff relevant to their care).

10. Help me to develop and maintain the patient-provider relationship.

A few more observations about acute care nurses

Primary communication is still talking on the phone or in person. And nurses still rely on paper; It’s fast, easy and unrestricted.

Even though nurses often rely on paper, don’t underestimate their technology savvy. They are very capable users. Any tool or solution just has to be flexible enough to match their unpredictable workflow.

Nurses are never empty-handed. It’s up to us as healthcare IT providers to make products worth carrying around.

Did we get it right?

Understanding our users is fundamental for delivering well-designed products that integrate into their workflow.  As we develop new products for nurses, we will use the tenets above to ensure we create meaningful solutions that enhance their experience with our products.

Do you see these same fundamental needs in your organization? Which ones have the most impact on your being able to provide the best patient care possible? Have we missed any important needs? Please share your thoughts in the comments below.

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About the author

Ross Teague, Ph.D., director of user experience research, leads the cross-functional team that provides user-experience (UX) and user-centered design (UCD) support for Allscripts. His team provides the research, design (conceptual and detailed) and evaluation necessary for the UX needs. Ross also manages the Allscripts effort to meet Meaningful Use UCD requirements and update of our development process to include UCD activities and measures. Prior to joining Allscripts, Ross was partner and director of research at Insight Product development, a design and strategy firm specializing in the planning and development of medical devices. Prior to Insight, Ross worked as a human factors psychologist in a business and design services group at Intel, helping to develop internet based products for companies outside of Intel. Ross holds a Ph.D. in Applied Cognitive Psychology and Human Factors.

4 COMMENTS on 10 things acute care nurses need to succeed


Holly Mathis says:

10/25/2013 at 7:37 am

This is spot on. But it is not only relevent to acute care nurses but most nurses in general. We now not only are nurses but have to be IT (at least to some degree), social workers, secretaries, etc. With all of the changes that are occuring in health care nursing faces the biggest impact as most changes/jobs/tasks fall smack dab in the nurses lap.

    Ross Teague says:

    10/30/2013 at 8:16 am

    Thanks for your feedback, Holly. You’re right that many of these themes probably apply across all nursing. Nurses juggle many different tasks and it’s good to hear that what we’ve learned has relevance to most nurses. It’s up to us to find a way to make their lives easier. The context of this research was acute care environments and we wanted to be careful about generalizing across all nurses. We plan on doing the same level of in-depth study with ambulatory nurses as well.


Mary Johnson says:

10/31/2013 at 12:35 pm

I agree with the article. I understand that this generation of nurses are trail blazers in the IT world for future nurses to come. Just as the introduction to computers in the beginning, trying to type a document was a daunting task, then comes Windows. IT for nurses need to be very user friendly without having much thought needed to operate the system. The EMR system that I use has summary pages that takes to much time to load, to much information and is not user friendly for nurses. Nurses should be able to design the way the EMR record looks to her/him to ensure she dots all of her I’s and crosess all of her T’s and can find the information she needs with as little clicks as possible, then, and maybe then will the paper go away.

Ross Teague says:

11/04/2013 at 1:49 pm

Thanks for your thoughts, Mary. I agree – nurses’ input is very important to solution design, and making sure our products fit nurse workflows is why it’s so important for us to spend the time in the field watching, interacting with, and learning from our clients. And making it work like nurses want/expect is great especially if it helps reduce the number of clicks to get to the right information.


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