A grounded theory model of onduty critical care nurses' information behavior

Purpose Critical care nurses' work is rich in informative interactions. Although there have been posthoc self report studies of nurses' information seeking, there have been no observational studies of the patterns of their onduty information behavior. This paper seeks to address this issue. Designmethodologyapproach This study used participant observation and in context interviews to describe 50 hours of the observable information behavior of a representative sample of critical care nurses in a 20bed critical care unit of a community nonteaching hospital. The researcher used open, in vivo and axial coding to develop a grounded theory model of their consistent pattern of multimedia interactions. Findings The resulting Nurse's PatientChart Cycle describes their activities during the shift as centering on a regular alternation between interactions with the patient and with the patient's chart in various record systems, clearly bounded with nursing report interactions at the beginning and the end of the shift. The nurses' demeanor markedly changed between interactions with the chart and interactions with the patient. Their attention was focused on patientspecific information. They had almost no time or opportunity to consult published sources of information while on duty. Originalityvalue Libraries often provide nurses with information services that are based on academic models of information behavior. Clinical information systems are designed more for medicolegal record keeping than for nursing care. Understanding the reality of nurses' onduty information behavior may guide librarians and systems designers in the provision of more appropriate systems and services.