Implementation of Medical Research Findings through Insulin Protocols: Initial Findings from an Ongoing Study of Document Design and Visual Display

Abstract

Medical personnel in hospital intensive care units routinely rely on protocols to deliver some types of patient care. These protocol documents are developed by hospital physicians and staff to ensure that standards of care are followed. Thus, the protocol document becomes a de facto standing order, standing in for the physician's judgment in routine situations. This article reports findings from Phase I of an ongoing study exploring how insulin protocols are designed and used in intensive care units to transfer medical research findings into patient care “best practices.” We developed a taxonomy of document design elements and analyzed 29 insulin protocols to determine their use of these elements. We found that 93% of the protocols used tables to communicate procedures for measuring glucose levels and administering insulin. We further found that the protocols did not adhere well to principles for designing instructions and hypothesized that this finding reflected different purposes for instructions (training) and protocols (standardizing practice).

The Roles of Technical Communication Researchers in Design Scholarship

“…Web 2.0 Interfaces (Potts & Jones, 2011;Rawlins & Wilson, 2014;Sherlock, 2009;Zdenek, 2007) . Instructions/Manuals (Catanio & Catanio, 2010;Friess, 2010Friess, , 2011Ganier, 2009;Longo, Weinert, & Fountain, 2007;Tebeaux, 2008;Willerton & Hereford, 2011) . Websites (Albers, 2009;Andrews et al, 2012;Cushman, 2014;O'Hara, 2004;Richards 2009;St.…”

“…This question requires us to take inventory of what types of artifacts show up most commonly in the technical communication literature. In the past 15 years, technical communication researchers have studied design through artifacts such as Posters (Lauer, 2012; Lauer & Sanchez, 2011; Ward, 2010); Databases and Content Management Systems (Bacha, 2012; Clark, 2007; Sapienza, 2002) Spaces (Carliner, 2000; Ramey, 2014; Salvo, Pflugfelder, & Prenosil, 2010; Welch, 2005) Software (Albers, 2011; de Jong & Lentz, 2001; Smart & Whiting, 2002; Wolfe & Neuwirth, 2001) Web 2.0 Interfaces (Potts & Jones, 2011; Rawlins & Wilson, 2014; Sherlock, 2009; Zdenek, 2007) Instructions/Manuals (Catanio & Catanio, 2010; Friess, 2010, 2011; Ganier, 2009; Longo, Weinert, & Fountain, 2007; Tebeaux, 2008; Willerton & Hereford, 2011) Websites (Albers, 2009; Andrews et al., 2012; Cushman, 2014; O’Hara, 2004; Richards 2009; St. Amant, 2005; Walker; 2002; Walters 2010).…”

“…Given the latest move toward UX as a design and development component of the technical communicator’s work then, it becomes necessary to review and revisit how design continues to be an important part of our field, in ways that include and even move beyond direct user testing. Evident in the technical communication research on design are terms, ranging from (to name a few) “document design” (Ding, 2000; Johnson, 2006; Lauer & Sanchez, 2011; Longo, Wienert, & Fountain, 2007), to “visual design,” (Brumberger, 2007; Kimball, 2013; Lauer, 2012; Rude, 2004; Varpio, Spafford, Schryer, & Lingard, 2007), to “participatory design” (Salvo, 2001; Spinuzzi, 2002), to “user-centered-design” (Schneider, 2005; Scott, 2008), to “design studies” (Wickman, 2014), to “information design,” (Ward, 2010; Williams, 2010; Willerton & Hereford, 2011) which is itself comprised of “fields such as architecture, advertising, cognitive psychology, computer science, graphic design, mass communication, information science, and rhetoric” (Cooke, 2003, p. 155). Some of these terms seem to coincide well.…”

Smart Home Technology Diffusion in a Living Laboratory

“…Most smart home technology products are accompanied by little information out of the box other than basic installation instructions. If we accept that, “As technical communication researchers have traditionally conceptualized instructions, the purpose of these documents is primarily to train or educate a user to perform a task” (Longo, Weinert, & Fountain, 2007, p. 448), then the technology traditionally ships with very little instructional information. Amazon’s Alexa, for example, comes with little more than instructions for connecting the device to your local Wi-Fi.…”

Communicating distrust: three cases

“…Within the past twenty years, there has been increased interest among rhetoric and professional communication scholars in biomedicine-specifically questions of agency and disease legitimization (Graham, 2009), diagnostic practice (McCarthy, 1991;, patient-practitioner discourse (Spears, 1998;Longo, Weinart, & Fountain 2007;Segal, 2008), and medical forms and genre theory (Barton, 2004;Schryer & Spoel, 2005). In terms of military rhetoric, specifically related to the OIF and OEF conflicts, scholarship in rhetorical studies (primarily in Speech Communication) has focused mainly on mass media construction of war (Achter, 2010), video games and war (Stahl, 2006), and the Bush administration's sale of the war on terrorism (Jamieson, 2007;Winkler, 2007;John, Domke, Coe, & Graham, 2007;Zarefsky, 2007) (Helmick et al, 2006).…”