title: Technology-mediated awareness: facilitating the handling of (un)wanted interruptions in a hospital setting.
abstract: BACKGROUND
  Nurses' work in hospital departments is highly collaborative and includes communication with a variety of actors. To further support nurses' communications, wireless phones, on which nurses receive both nurse calls and ordinary phone calls, have been introduced. However, while they ensure high availability among the mobile nurses, these phones also contribute to an increased number of interruptions.
  
  
  OBJECTIVE
  This paper aims to discover whether all interruptions caused by the wireless phones are unwanted. Further, it investigates how nurses handle these interruptions in a hospital setting in order to construct a foundation for guidelines to use in designing these types of systems.
  
  
  METHODS
  Qualitative and ethnographically inspired fieldwork, including workshops with both ordinary and student nurses from a Norwegian hospital, was undertaken. Patients from two hospital departments were interviewed.
  
  
  RESULTS
  Nurses struggle to handle interruptions caused by the wireless nurse call system. Deciding whether to abort an activity or not to respond to an interruption is regarded as stressful. The decision is further complicated by the complex nature of the interruptions. At the same time, patients anticipate that nurses are able to make these judgements with limited information. Nurses' work is highly collaborative, and nurses depend on one another to carry out their work and manage interruptions.
  
  
  CONCLUSIONS
  The dual nature of the interruptions is complex, and whether an interruption is wanted or unwanted depends on many factors. Nurses manage interruptions mainly by making their own activities visible and monitoring colleagues' work. Therefore, nurses' awareness of colleagues' activities is a key factor in how they handle interruptions in the form of nurse calls.
authors.affiliation: Department of Telematics, Norwegian University of Science and Technology, O.S. Bragstads plass 2a, N-7491 Trondheim, Norway; Norwegian Research Centre for Electronic Patient Records, Medical Technology Research Centre, N-7491 Trondheim, Norway. Electronic address: joakim@item.ntnu.no.
authors.forename: Joakim
authors.initials: J
authors.lastname: Klemets
authors.affiliation: Norwegian Research Centre for Electronic Patient Records, Medical Technology Research Centre, N-7491 Trondheim, Norway; Department of Computer and Information Science, Norwegian University of Science and Technology, Sem Sælandsvei 7-9, N-7491 Trondheim, Norway; SINTEF Technology and Society, Department of Safety Research, PO Box 4760 Sluppen, 7465 Trondheim, Norway.
authors.forename: Tor Erik
authors.initials: TE
authors.lastname: Evjemo
mesh_terms: D001291:Attitude of Health Personnel; D001364:Awareness; D040421:Cell Phone; D017598:Efficiency, Organizational; D006272:Health Facility Environment; D006747:Hospital Communication Systems; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control*; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D013647:Task Performance and Analysis; D059015:Wireless Technology / Q000706:statistics & numerical data*
keywords: Awareness; Collaboration; Communication; Interruptions; Qualitative research