Patient care information and its use by nurses: 'Becoming informed'

A major problem that nurses face at the start of each shift is the amount of information they receive in relation to the patients allocated to their care. The patient may have been in the ward for many days and the nurse has abundant previous information about them. The patient may be a newly admitted and the only information nurses have is their name and that of the consultant. Not only is information needed at the start of the shift, but there are also ongoing needs throughout the shift. Therefore there is a constant process of giving and gathering information.
A qualitative approach using interviews and participant observation was chosen as the most appropriate form of investigation. Ten nurses were interviewed, then observed both at handover and for some hours afterwards. The collected data were analysed using a grounded theory approach. Because of data and time constraints only an initial conceptual framework could be developed and presented in this work.
It was found that nurses both actively seek and are passively given information, which they use for providing patient care. A continuum was found ranging from low to high for both the nurses' knowledge of the patient and the patient's condition, as well as the nurses' clinical knowledge and experience, that has an affect on these activities. This gathering of information can be likened to nurses "learning" about the patient much as one 'learns' the meaning of a picture. Initially one passively absorbs the scene but then the person looks more closely to fill in the details raised by questions they may have.
The process of gathering information needed for patient care is a complex intertwining of many factors relating both to the nurse and the situation. This has implications in the way information is communicated at each nursing change of shift if ongoing care is to be continued appropriately.