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First published November 26, 2002 as JAMIA PrePrint; doi:10.1197/jamia.M1175
Journal of the American Medical Informatics Association 2003;10(2):177-187
© 2003 American Medical Informatics Association

A more recent version of this article appeared on March 1, 2003
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Submitted on June 13, 2002
Accepted on November 13, 2002

THE EFFECT OF COMPUTER-GENERATED REMINDERS ON CHARTING DEFICIENCIES IN THE ICU

Thomas A. Oniki PhD1*, Terry P. Clemmer MD2, and T. Allan Pryor PhD3

Affiliation of the authors: 1 Oracle Corporation, Redwood Shores, CA; 2 LDS Hospital Department of Critical Care, University of Utah Departments of Internal Medicine and Medical Informatics, Salt Lake City, UT; 3 University of Utah Department of Medical Informatics (emeritus), Salt Lake City, UT

* To whom correspondence should be addressed.

Objective To examine the effect of computer-generated reminders on nurse charting deficiencies in two Intensive Care Units.

Design Nurses caring for a group of 60 study patients received patient-specific paper reminder reports when charting deficiencies were found at mid-day. Nurses caring for a group of 60 control patients received no reminders. A group of 60 retrospective patients was also formed.

Measurements The average numbers of charting deficiencies at the end of the shift in each of the three groups were compared using two planned orthogonal contrasts.

Results The average in the study group patients was 1.02 deficiencies per day per patient, while the control group average was 1.40 deficiencies per day per patient (p=.001). The average number of end-of-shift deficiencies in the pooled prospective (study/control) population was 1.21 deficiencies per day per patient, compared to the average in the retrospective group of 1.56 deficiencies per day per patient (p<.001).

Conclusion The decrease was likely due both to the appropriate response of the nurses to the reminders and to a learned attentiveness to the tasks on the part of the nurses who cared for study patients. Greater gains were hindered by incomplete "coupling" of the reminders to the end-of-shift deficiencies and by inaccuracies in the reminders.




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