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Some observation chart formats perform better than others

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Observation charts that are based on drawn dots and an integrated colour-based scoring system result in fewer recording errors, according to an Australian study.

Researchers from the University of Queensland in Brisbane set out to systematically evaluate the impact of several design features on the detection of patient deterioration on observation charts with early-warning scoring-systems.

“Several individual design features can affect novice chart-users’ ability to detect patient deterioration”

Study authors

They noted that previous research had shown that observation chart design affected the speed and accuracy with which abnormal observations were detected, but little was known about the contribution of individual design features to these effects.

As a result, they compared a number of design factors. For example, they assessed drawn dots versus written numbers for data recording, and an integrated colour-based system versus non-integrated tabular system for scoring.

They also looked at scoring-row placement – grouped versus separate – and variations within-participants and scores – present versus absent – and between-participants by random assignment.

The study involved 205 novice chart-users who completed 64 trials where they saw real patient data presented on an observation chart.

Each participant saw eight cases on each of eight designs, of which four contained abnormal observations.

student nurse observing

student nurse observing

They were asked to assess whether any of the observations were physiologically abnormal, or whether all were normal. Response times and error rates were recorded for each design.

The study authors said participants responded faster and made fewer errors using drawn-dot observations and an integrated colour-based scoring-system.

In addition, they found participants responded faster using grouped scoring-rows when scores were absent, but separate scoring-rows when scores were present.

“Our findings suggest that several individual design features can affect novice chart-users’ ability to detect patient deterioration, the researchers said in the Journal of Advanced Nursing.

“More broadly, the study further demonstrates the need to evaluate chart designs empirically,” they added.

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