title: Vital sign documentation in electronic records: The development of workarounds.
abstract: Workarounds are commonplace in healthcare settings. An increase in the use of electronic health records has led to an escalation of workarounds as healthcare professionals cope with systems which are inadequate for their needs. Closely related to this, the documentation of vital signs in electronic health records has been problematic. The accuracy and completeness of vital sign documentation has a direct impact on the recognition of deterioration in a patient's condition. We examined workflow processes to identify workarounds related to vital signs in a 372-bed hospital in Sweden. In three clinical areas, a qualitative study was performed with data collected during observations and interviews and analysed through thematic content analysis. We identified paper workarounds in the form of handwritten notes and a total of eight pre-printed paper observation charts. Our results suggested that nurses created workarounds to allow a smooth workflow and ensure patients safety.
authors.affiliation: The University of Sheffield, UK; Linnaeus University, Sweden.|Linnaeus University, Sweden.
authors.forename: Jean E
authors.initials: JE
authors.lastname: Stevenson
authors.affiliation: Kalmar County Hospital, Sweden.|Linnaeus University, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Israelsson
authors.affiliation: Linnaeus University, Sweden.
authors.forename: Gunilla
authors.initials: G
authors.lastname: Nilsson
authors.affiliation: Linnaeus University, Sweden.
authors.forename: Goran
authors.initials: G
authors.lastname: Petersson
authors.affiliation: The University of Sheffield, UK.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Bath
mesh_terms: D000328:Adult; D004282:Documentation / Q000379:methods* / Q000639:trends; D057286:Electronic Health Records / Q000706:statistics & numerical data / Q000639:trends*; D005260:Female; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012985:Software Design; D013548:Sweden; D055986:Vital Signs; D057188:Workflow
keywords: electronic health records; healthcare professionals; patient safety; vital signs; workarounds