Integrated Information Displays for ICU Nurses: Field Observations, Display Design, and Display Evaluation

Preventable adverse events are one of the leading causes of patient mortality in hospitals. Many of these adverse events occur in Intensive Care Units (ICUs) where nurses often work under cognitive, perceptual, and physical overloads. One contributing factor to these overloads is the display of treatment orders, monitoring information, and equipment status on numerous, spatially separated information displays. If these separate displays were combined into a single integrated display at the bedside, the display could potentially reduce nursing workload and improve nurse awareness of the patients' treatment plans and physiological status. We performed a study with three parts. First, we observed ICU nurses at work and found that task-relevant information was often presented in a sub-optimal format, it was unavailable at the point of care and/or it was laborious to retrieve. Second, we designed an integrated information display that presents the information needed by nurses at the patient bedside in a more optimal format. Finally, we evaluated paper-based prototypes of both the integrated display and existing ICU displays with pilot participants. The results for participants in a pilot study showed that nurses using the integrated display could answer questions about the patient's status and treatment significantly faster and more accurately. Integrated displays could potentially reduce adverse events in ICUs and reduce cognitive overloads.