Nurse Cognition, Decision Support, and Barcode Medication Administration

Abstract

This article synthesizes theoretical perspectives related to nurse cognition. We present a conceptual model that can be used by multiple stakeholders to study and contemplate how nurses use clinical decision support systems, and specifically, Barcode-Assisted Medication Administration, to make decisions during the delivery of care. Theoretical perspectives integrated into the model include dual process theory, the Cognitive Continuum Theory, human factors engineering, and the Recognition-Primed Decision model. The resulting framework illustrates the process of nurse cognition during Barcode-Assisted Medication Administration. Additionally, the model includes individual or human and environmental factors that may influence nurse cognition and decision making. It is important to consider the influence of individual, human, and environmental factors on the process of nurse cognition and decision making. Specifically, it is necessary to explore the impact of heuristics and biases on clinician decision making, particularly related to the development of alarm and alert fatigue. Aided by the proposed framework, stakeholders may begin to identify heuristics and cognitive biases that influence the decision of clinicians to accept or override a clinical decision support system alert and whether heuristics and biases are associated with inappropriate alert override.

Factors Influencing Medication Administration Outcomes Among New Graduate Nurses Using Bar Code–Assisted Medication Administration

“…To guide methodological decisions about study design, we used a research model to illustrate study variables adapted from a conceptual model published by Sloss and Jones. 20 The conceptual model synthesizes theories on human cognition and proposes a framework showing the process of nurse cognition, along with factors that may influence nurse decision-making during BCMA. The primary objectives of this study were (1) to examine patterns of the decision to administer medication after alert generation among new graduate nurses and (2) to examine the influence of human and environmental factors on the decision to administer after alert generation among new graduate nurses.…”

“…To guide methodological decisions about study design, we used a research model to illustrate study variables adapted from a conceptual model published by Sloss and Jones 20 . The conceptual model synthesizes theories on human cognition and proposes a framework showing the process of nurse cognition, along with factors that may influence nurse decision-making during BCMA.…”