The information seeking of on-duty critical care nurses: evidence from participant observation and in-context interviews.

OBJECTIVES: An observational study describes on-duty nurses' informative behaviors from the perspective of library and information science, rather than patient care,. It reveals their information sources, the kinds of information they seek, and their barriers to information acquisition.
METHODS: Participant observation and in-context interviews were used to record in detail fifty hours of the information behavior of a purposive sample of on-duty critical care nurses on twenty-bed critical care unit in a community hospital. The investigator used rigorous ethnographic methods-including open, in vivo, and axial coding--to analyze the resulting rich textual data.
RESULTS: The nurses' information behavior centered on the patient, seeking information from people, the patient record, and other systems. The nurses mostly used patient-specific information, but they also used some social and logistic information. They occasionally sought knowledge-based information. Barriers to information acquisition included illegible handwriting, difficult navigation of online systems, equipment failure, unavailable people, social protocols, and mistakes caused by people multitasking while working with multiple complex systems. Although the participating nurses understood and respected evidence-based practice, many believed that taking time to read published information on duty was not only difficult, but perhaps also ethically wrong. They said that a personal information service available to them at all hours of the day or night would be very useful.
CONCLUSIONS: On-duty critical care nursing is a patient-centric information activity. A major implication of this study for librarians is that immediate professional reference service--including quality and quantity filtering-may be more useful to on-duty nurses than do-it-yourself searching and traditional document delivery are.