Abstract
To understand how healthcare technologies are used in practice and evaluate them, researchers have argued for adopting the theoretical framework of Distributed Cognition (DC). This paper describes the methods and results of a study in which a DC methodology, Distributed Cognition for Teamwork (DiCoT), was applied to study the use of infusion pumps by nurses in an Intensive Care Unit (ICU). Data was gathered through ethnographic observations and interviews. Data analysis consisted of constructing the representational models of DiCoT, focusing on information flows, physical layouts, social structures and artefacts. The findings show that there is significant distribution of cognition in the ICU: socially, among nurses; physically, through the material environment; and through technological artefacts. The DiCoT methodology facilitated the identification of potential improvements that could increase the safety and efficiency of nurses’ interactions with infusion technology.
Highlights
There is a need to understand how health practitioners use infusion pumps in context, to improve the design of the devices; incidents occasionally occur during infusion administration, that may compromise patient safety, in general wards [1,2,3] and in the Intensive Care Unit (ICU) [4,5]
This paper describes the methods and results of a study in which a methodology based on DC theory, Distributed Cognition for Teamwork (DiCoT) [17,18], was applied to study the use of computer-based infusion pumps in the ICU of a London-based teaching hospital
Taking a step in this direction, this study focused on understanding the socio-technical system involved in infusion administration in the ICU, with the aim of informing the design of safer and user-friendlier infusion technology
Summary
There is a need to understand how health practitioners use infusion pumps in context, to improve the design of the devices; incidents occasionally occur during infusion administration, that may compromise patient safety, in general wards [1,2,3] and in the Intensive Care Unit (ICU) [4,5]. This paper describes the methods and results of a study in which a methodology based on DC theory, Distributed Cognition for Teamwork (DiCoT) [17,18], was applied to study the use of computer-based infusion pumps in the ICU of a London-based teaching hospital. The study aimed to deliver an improved understanding of the situated use of infusion pumps, which could help improve the safety and usability of the devices, while testing the utility and practicality of applying DiCoT to the study of a socio-technical healthcare system such as the ICU. In the seemingly chaotic environment, the team works together in a coordinated way and relies on sophisticated patient care technology, such as smart infusion pumps
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