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Clinical information management, Communication, Electronic medical records, Nursing care



  1. Williams, Cynthia PhD, PT, MHS
  2. Hamadi, Hanadi PhD
  3. Cummings, Cynthia L. EdD, RN, CHSE, CNE


The incorporation of electronic medical records into nursing practice highlights the need to facilitate communication among nurses. The extensive use of information suggests that electronic medical records should be considered in the cognitive workspace to manage information and facilitate communication. The purpose of this study was to construct an integrative model to explain the role of electronic medical records in the cognitive workspace. This work is grounded in the Theory of Swift and Even Flow and Distributive Cognition. The Distributive Cognitive model views the workplace as a cognitive system, such that cognitive processes do not occur in individual clinicians, but as a collaborative effort among nurses. The Theory of Swift and Even Flow was used to explain the flow of information among nurses. We used a qualitative approach to gather data from nurses at local inpatient facilities. Seven focus groups among three facilities were completed (n = 34). A semistructured questionnaire guided the focus group sessions. The results suggest that electronic medical records contribute to the cognitive workspace by serving as a conduit for information to be collected and distributed. These systems may positively influence nursing care when the quality, quantity, and timeliness of information are optimized.