Documenting for whom? A symbolic interactionist analysis of technologically induced changes of nursing handovers

Abstract

This article employs a symbolic interactionist perspective to analyse the act of 'taking others into account' as a premise for nurses' face-to-face reporting and documenting in patient record systems. Two case studies indicate that replacing faceto-face communication with extended employment of patient record systems may hinder the practical accomplishment of nursing handovers.

Research on nursing handoffs for medical and surgical settings: an integrative review

“…Networks of providers ranged from 11–20, were nonlinear, unpredictable and shaped by providers' information needs. Other authors concluded that replacing face‐to‐face handoffs with asynchronous electronic records would hinder nursing handoffs (Engesmo & Tjora ). Chaboyer et al .…”

“…Networks of providers ranged from 11-20, were nonlinear, unpredictable and shaped by providers' information needs. Other authors concluded that replacing face-to-face handoffs with asynchronous electronic records would hinder nursing handoffs (Engesmo & Tjora 2006). Chaboyer et al (2010) discovered that patients participated in less than one half of bedside handoffs and that nurses' printed sheets played a primary role during and after handoffs.…”

How to improve change of shift handovers and collaborative grounding and what role does the electronic patient record system play? Results of a systematic literature review

“…Documentation systems used for handovers, e.g. electronic patient records, were found problematic because they did not provide reader customized information [64]. When different modes of communication were compared "computerized and discussed" ranked first [71], employing "technology only" approaches proved inferior to in person handovers [79].…”

“…Electronically supported handovers either utilized a dedicated handover application [36,[59][60][61][62][63]65,66,[68][69][70][72][73][74][75][76][77][78] or employed the electronic medical/patient record system to support the clinicians in handing over patients [64,67]. The first type of tools could be further subdivided into those that imported data from the electronic medical/patient record system and other information systems [59][60][61][62]65,68,69,72,73,[75][76][77][78] and those that were mere standalone solutions [36,63,66,70,74] or an electronic presentation tool [79].…”

How Triage Nurses Use Discretion: a Literature Review

“…Future research might find inspiration in interactionist literature on topics such as distributed decision-making (Goodwin, 2014;Rapley, 2008), frame analysis (Goffman, 1974) and conversation analysis (Sacks, 1992). Based on such literature, it could be argued that the interactionist aspect is inherent in nurses' discretionary reasoning, in the Meadian sense that they always take others into account when they reason about patients' urgency (see Engesmo & Tjora, 2006). This idea demonstrates one of the ways in which interactionist and epistemic discretion might be interrelated.…”