Sharon McLane - Academia.edu (original) (raw)

Papers by Sharon McLane

PubMed, Nov 14, 2009

Nurses prepare knowledge representations, or summaries of patient clinical data, each shift. Thes... more Nurses prepare knowledge representations, or summaries of patient clinical data, each shift. These knowledge representations serve multiple purposes, including support of working memory, workload organization and prioritization, critical thinking, and reflection. This summary is integral to internal knowledge representations, working memory, and decision-making. Study of this nurse knowledge representation resulted in development of a taxonomy of knowledge representations necessary to nursing practice.This paper describes the methods used to elicit the knowledge representations and structures necessary for the work of clinical nurses, described the development of a taxonomy of this knowledge representation, and discusses translation of this methodology to the cognitive artifacts of other disciplines. Understanding the development and purpose of practitioner's knowledge representations provides important direction to informaticists seeking to create information technology alternatives. The outcome of this paper is to suggest a process template for transition of cognitive artifacts to an information system.

PubMed, 2012

Research has established the pivotal role of cognitive artifacts to human information visualizati... more Research has established the pivotal role of cognitive artifacts to human information visualization, the reduction of memory load, and critical thinking. A long-standing nursing practice is the development of a personal cognitive artifact that summarizes the clinical condition and plan of care for the patient(s) in the care of the nurse. Distributed cognition establishes the importance of the role of cognitive artifacts to the cognition of each individual. A feature/function of electronic health record applications is to supply a real-time clinical overview of a patient's clinical condition and care needs, which is often referenced as a patient clinical summary. Research regarding the requirements of electronic clinical summaries to support clinician cognition has not been reported to date. This paper reports the results of initial research to establish foundational principles for the development of EHR patient clinical summaries that support the cognition and critical thinking of the registered nurse.

Oncology Nursing Forum, 2005

PubMed, 2006

Dichotomous identification keys are used throughout biology for identification of plants, insects... more Dichotomous identification keys are used throughout biology for identification of plants, insects, and parasites. However, correct use of identification keys can be difficult as they are not usually intended for novice users who may not be familiar with the terminology used or with the morphology of the organism being identified. Therefore, we applied cognitive engineering principles to redesign a parasitology identification key for the Internet. We addressed issues of visual clutter and spatial distance by displaying a single question couplet at a time and by switching to the appropriate next couplet after the user made a choice. Our analysis of the original paper-based key versus the Web-based approach found that of 26 applicable cognitive engineering principles, the paper key did not meet 4 (15%) and partially met 11 (42%). In contrast, the redesigned key met 100% of 32 applicable cognitive engineering principles.

Springer eBooks, Jun 14, 2018

Nursing administration quarterly, 1996

Journal of Nursing Administration, 2011

The heightened focus on health information technology deployment, specifically the electronic hea... more The heightened focus on health information technology deployment, specifically the electronic health record, has magnified the need for the knowledge and skills of informaticians. The clinical informatician is frequently confused with system analyst and project management roles. In this article, the authors explore the knowledge and skills of informaticians and how to determine the skill combinations most suited to an organization and compare the roles of informaticians, project managers, and information technology professionals.

Studies in health technology and informatics, 2009

Nurses prepare a summary of patient information that they consult and update throughout the shift... more Nurses prepare a summary of patient information that they consult and update throughout the shift. This document is believed to be integral to cognition, working memory, and decision-making. While serving as a key support to nursing practice, this summary also represents risks to patient safety. Characterized as a PCCAT, or Personally Created Cognitive Artifact, studies of this document in the context of nursing practice have not been reported. The absence of reported research, the importance of the document to nurse cognition and practice, and related safety risks prompted the research that this paper discusses. A taxonomy was developed through the analysis and coding of 151 PCCATs. Further analysis and mapping provided an ontology of the PCCAT. Content differences were noted between nursing units and among nurses. This may reflect differences in unit-based culture and/or differences in the patient complexity. The interaction between culture and perceived complexity of practice is one of the great difficulties in generating automated information systems for clinical practice settings. This paper is part of a larger research protocol that explores meta-level knowledge structures and revision to the understanding of the granularity of nursing knowledge. Development of a taxonomy and ontology of the nurse PCCAT, an important component of the larger research protocol, is described in this paper.

Cin-computers Informatics Nursing, Mar 1, 2005

Nursing Management, May 1, 1992

This research was based upon the assumption that the PCCAT is an instance of a cognitive artifact... more This research was based upon the assumption that the PCCAT is an instance of a cognitive artifact. An early step in the program was to establish that the PCCAT is a cognitive artifact through a concept analysis using the process established by Walker and Avant (Walker & Avant, 2005), and is the subject of the first manuscript, "Conceptual Analysis: Externalizing Nursing Knowledge". We discovered that a concept analysis of cognitive artifacts had not been published, so we amended the plan and converted our concept analysis into a dual process. The purpose of the concept analysis was to clearly define the attributes and limitations of cognitive artifacts, and their antecedents, consequences, and external referents. Once the characteristics of the concept entitled 'cognitive artifact' had been established, the same concept analysis process was employed with the PCCAT. Finally, the attributes, limitations, antecedents, consequences, and external referents of the PCCAT were compared to those of the cognitive artifact. The process firmly established the PCCAT as an example of cognitive artifacts. This process placed PCCATs in the concept class of cognitive artifacts and allowing us to determine if other concepts are the same as the cognitive artifact, or only similar to but differing in a least one significant way. The concept analysis, establishing PCCATs as an instance of a cognitive artifact, enables assignment of the seven attributes of a cognitive artifact to the PCCAT, as established by Zhang and Patel (2006). The seven attributes are 1) reduction of user memory, 2) guiding recognition and understanding inferences to support rapid data assimilation, 3) augmenting user knowledge and internal representations,4) supporting user perceptions and cognition without requiring conscious effort of the user, 5) promoting more efficient and effective user action, 6) minimizing abstraction and support effective decision making, and 7) channeling decision making by maximizing accuracy and minimizing user effort. We also established that the PCCAT has an additional attribute not shared with cognitive artifacts, namely that the clinical

Holistic Nursing Practice, Oct 1, 1994

Health care is experiencing a paradigm shift that has the potential to redefine traditional roles... more Health care is experiencing a paradigm shift that has the potential to redefine traditional roles, systems, and practices. At Albert Einstein Medical Center in Philadelphia, Pennsylvania, the nursing organization has capitalized on this potential and has been energized by the array of opportunities for innovation and experimentation. The results of these efforts suggest that many of these changes not only are positive approaches to patient care but also promote staff leadership and an entrepreneurial spirit at the front line.

Cin-computers Informatics Nursing, May 1, 2009

Well-developed studies in nursing and related clinical fields have grown in depth and breadth ove... more Well-developed studies in nursing and related clinical fields have grown in depth and breadth over the past several decades, providing an ever-growing body of research that is potentially usable to guide practice. The evidence from these studies has spurred a movement in the public policy and professional sectors that supports and increasingly expects the use of evidence to improve practice and guide healthcare decisions. Evidence-based practice (EBP) has evolved in response to these expectations and guides judicious decisions about when and how to apply research. The foundation of the EBP process is a problem-solving approach to understanding and implementing clinical practice. The steps of the EBP process include use of the best available evidence, coupled with the practitioners’ clinical knowledge and consideration of patient values. M. D. Anderson Cancer Center is a values-driven, results-oriented comprehensive cancer center with an environment that supports building practice based on science rather than tradition. The development of an EBP program was further supported by a nursing culture that continually challenges nurses to improve care. The objective of developing an EBP program was to develop, encourage, and mentor more than 2500 nurses across the institution to improve patient care based on evidence. The program has multiple components that focus on each level of practice, from staff nurse to advance practice nurse. The main component of our program, developed in 2006, is the Evidence-Based Resource Unit Nurse (EBRUN) program. Nurses on each unit (inpatient and outpatient) receive the necessary education and support to take a leadership role in all aspects of EBP. Each EBRUN team has a mentor, an advanced practice nurse from within the institution, who provides ongoing guidance and support throughout the process of identifying and conducting EBP projects. Prior to program participation, each EB-RUN and mentor complete a 2-day class that provides the underpinnings of the research process and EBP principles. Mentors and EB-RUNs are also supported by doctoral-prepared nurse researchers, library support services, writing support, and interdisciplinary team support. Upon completion of the educational component of the program, the EB-RUN teams are asked to develop a project for their unit or in combination with other units. These EB-RUN teams have developed a diverse array of EBP projects that have served to change practice, improve quality, and create or update practice guidelines. Project outcomes have been presented internally and nationally. Key Points: •Track EBP projects •Database design for EBP •Benefits of a database for EBP projects cin20031.qxd 4/22/09 8:09 PM Page 131

ion through real-time documentation of events. The event log maintained during a cardiac resuscit... more ion through real-time documentation of events. The event log maintained during a cardiac resuscitation shares many, but not all, of the attributes of a cognitive artifact. It is not

Amia Annual Symposium Proceedings Amia Symposium Amia Symposium, 2009

Nursing Informatics Proceedings of the International Congress on Nursing Informatics, 2012

Amia Annual Symposium Proceedings Amia Symposium Amia Symposium, Feb 1, 2005

Effective EHR systems provide direct benefit to clinical practitioners, patient care delivery, an... more Effective EHR systems provide direct benefit to clinical practitioners, patient care delivery, and clinical research. At the same time, these systems offer information that can support managers in assessment of clinical practice patterns, utilization of practice protocols, identification of quality and process improvement opportunities, and practice patterns of individuals and groups. The awareness and recognition by managers of the value and use of the information contained in electronic documentation systems influences the dissemination of related benefits, insights, and improvement opportunities. Further, regular managerial involvement in review of EHR data and reports can significantly influence the scope and efficiency of the resulting process, practice, and outcomes gains that may be achieved.