Interruptions and cognitive processes in nursing: Review, analysis, recommendations

Abstract

Nurses spend more time with patients than other health care providers, and patient outcomes are impacted by nursing care quality. Thus, enhancements in nursing performance can lead to improvements in patient safety. Results of our comprehensive literature review (DeLucia, Ott, & Palmieri, in press) indicated that numerous factors affect the performance of nurses. These include cognitive factors (interruptions, cognitive processes), physical factors (musculoskeletal disorders, environment), and organizational factors (work hours, staffing). Here, we focus on cognitive factors. Nurses' work is cognitively demanding. Nursing involves multi-tasking, relies on procedural and prospective memory, and occurs under frequent interruptions. We discuss interruptions and cognitive processes in nursing and provide a conceptual analysis and recommendations. We conclude that the nurses' work system does not accommodate limitations and capabilities of the nurse, particularly limits in cognitive processes. The field of human factors and ergonomics is uniquely suited to redesign the nurses' work system to enhance nursing performance and improve patient safety. Of particular importance for future research is the study of interruptions and cognitive processes in nursing.