Table 2.
# Goal State/Decision | Memory Recall | System Support | Comments |
---|---|---|---|
Open chart | Patient name – Match | Name list | |
Evaluate case Dose adjustment |
General medical knowledge | Electronic chart, case description | Patient data on screen and in notes |
1 Drip – DC / Reorder | DC/Reorder or new order? DS available? Which faster? | none | Strategy dependent on experience, skill |
B Reorder drip | Procedural knowledge | Context menu | |
2 Bolus – New Order | PTT values near normal, bolus order also needed | n/a | Decision driven by medical reasoning |
A New bolus | Procedural knowledge | Context menu | Order A cancelled |
3 Heparin IV order set 4 Heparin IV individual orders |
Order set is available, may be preferable to individual orders Individual orders may be simpler, include calculation |
none none |
Heuristic decision, no prior experience w set Previous decision reversed, set confusing |
A New bolus B Reorder drip |
Procedural knowledge Procedural knowledge |
Dose calculation Context menu |
DS triggers reminder Aborted – needs DS |
5 Drip – New Order | New orders procedure triggers auto calculation | none | Also needs to cancel current drip order |
-- Error Cancellation of the previous order also deleted the just entered but unsigned bolus order -- | |||
A New bolus | Procedural knowledge | Dose calculation | DS triggers reminder |
D Sign orders | Sign button | Saves current orders | |
B New drip | Procedural knowledge | Dose calculation | Second attempt |
C Order PTT laboratory | Corollary order | Reminder | Included in bolus DS |
D Sign orders | Sign button | Saves current orders |