Sarah Collins

Publications (8)6.58 Total impact

• Article: Discuss now, document later: CIS/CPOE perceived to be a 'shift behind' in the ICU.

  Sarah Collins, Suzanne Bakken, David Vawdrey, Enrico Coiera, Leanne M Currie
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  ABSTRACT: Effective communication is essential to safe and efficient patient care. We aimed to understand the current patterns and perceptions of communication of common goals in the ICU using the distributed cognition and clinical communication space theoretical frameworks. We conducted a focus group and 5 interviews with ICU clinicians and observed 59.5 hours of interdisciplinary ICU morning rounds. Clinicians used a CIS/CPOE system and paper artifacts for documentation; yet, preferred verbal communication as a method of information exchange because they perceived that the documentation was often not updated or efficient for information retrieval. These perceptions that the CIS/CPOE is a "shift behind" may lead to a further reliance on verbal information exchange, which is a valuable clinical communication activity, yet, is subject to information loss. Electronic documentation tools that, in real time, capture information that is currently verbally communicated may increase the effectiveness of communication.
  Studies in health technology and informatics 01/2010; 160(Pt 1):178-82.
• Article: Nerve injury during uterosacral ligament fixation: a cadaver study.

  Sarah A Collins, Sherry A Downie, Todd R Olson, Magdy S Mikhail
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  ABSTRACT: The objective of this study was to identify nerve(s) vulnerable to entrapment during uterosacral ligament fixation (USLF), which could cause postoperative lower extremity pain previously described in the literature. Preserved cadavers in a medical anatomy course were used. Before the students' pelvic dissections, a 2-0 prolene suture was placed in the middle third of each left uterosacral ligament visualized. The sutures were re-evaluated at the end of the course. Nine sutures remained in place after the course, and one entrapped a nerve. It was part of the inferior hypogastric plexus, included fibers from S2 and S3, and radiated to the bladder and rectum. The posterior femoral cutaneous nerve was lateral and posterior to this nerve. The inferior hypogastric plexus is vulnerable during USLF. Entrapment of S2 and S3 fibers could cause pain in their respective dermatomes and could be responsible for the postoperative pain previously described.
  International Urogynecology Journal 02/2009; 20(5):505-8. · 1.83 Impact Factor
• Article: Implementing evidence-based nursing with student nurses and clinicians: uniting the strengths.

  Pamela B de Cordova, Sarah Collins, Lora Peppard, Leanne M Currie, Ronda Hughes, Mary Walsh, Patricia W Stone
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  ABSTRACT: Implementing evidence-based practice (EBP) is challenging for both clinicians and students. Facilitating collaboration among students and clinicians can improve the process of both teaching EBP in the academic setting and utilizing EBP in the clinical setting. A unique and successful EBP program is described, and other schools are encouraged to emulate this model.
  Applied nursing research: ANR 12/2008; 21(4):242-5. · 0.87 Impact Factor
• Article: Parent-adolescent communication about sexual intercourse: an analysis of maternal reluctance to communicate.

  Vincent Guilamo-Ramos, James Jaccard, Patricia Dittus, Sarah Collins
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  ABSTRACT: A unified theory of behavior was applied to parent-adolescent communication about sexual intercourse to understand why some mothers speak less often with their children about not having sexual intercourse. According to the theory, parental decisions or intentions to engage in such conversations are a function of expectancies, social norms, self-concept, emotions, and self-efficacy. Data were collected from a random sample of 668 mother-adolescent dyads recruited from middle schools located in the Bronx community of New York City. Data were collected via self-administered surveys. Mother and adolescent reports on the frequency of parent-adolescent communication about sexual intercourse were obtained. Adolescents and mothers reported how often the mother had discussed 21 topics related to sexual behavior. Results supported the utility of the framework for understanding parent-adolescent communication about sexual intercourse. Significant maternal correlates included (a) expectancies about lacking knowledge, being embarrassed and encouraging children to think maturely and focus on school; (b) self-concept and perceiving that mothers who didn't talk with their children about sex were irresponsible; (c) emotions about feeling relaxed and comfortable; and (d) self-efficacy about the ease of talking with one's child. Implications for family based prevention programs are discussed.
  Health Psychology 12/2008; 27(6):760-9. · 3.87 Impact Factor
• Source

  Available from: Suzanne Bakken

  Article: Information needs related to antibiotic prescribing while using CPOE.

  Sarah Collins, Suzanne Bakken, James J Cimino, Leanne M Currie
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  ABSTRACT: Antimicrobial resistance is an important patient safety issue related to inappropriate antibiotic use. As part of the Infobutton project, we examined antibiotic prescribing-related information needs of clinicians using CPOE. During 3 hours of observation, 20 information needs were observed, 74% were met. Understanding the information needs of clinicians related to antibiotic prescribing may help identify methods to meet information needs via the Infobutton manager and thereby improve the judicious use of antibiotics.
  AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium 02/2007;
• Article: A methodology for meeting context-specific information needs related to nursing orders.

  Sarah Collins, Suzanne Bakken, James J Cimino, Leanne Currie
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  ABSTRACT: Nurse information needs at the point of care exist; however, once provided with access to resources, nurses seek evidence-based answers. The success of answering an information need through an automated Infobutton relies on the program's ability to anticipate a clinician's question. This study's six process methodology aims to meet context-specific information needs related to clinical information system (CIS) nursing orders. Context-specific questions were derived from nurse generic questions generated from nurse focus group data, observational data, and an established taxonomy. The context-specific questions, were filtered by nursing order semantic type within a logical clinical context cluster (LCCC), which is a clinical association identified from the nurse perspective. Nursing orders of the same semantic type are associated with similar types of nurse information needs and are used to assess Internet-based resources for the capability to answer those information needs. LCCCs help identify resources and CIS areas ripe for an Infobutton.
  AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium 02/2007;
• Source

  Available from: Suzanne Bakken

  Article: Multitasking by clinicians in the context of CPOE and CIS use.

  Sarah Collins, Leanne Currie, Vimla Patel, Suzanne Bakken, James J Cimino
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  ABSTRACT: Interest in studying distractions and interruptions in the context of clinician workflow has increased in light of evidence that these events may negatively impact patient safety. Additionally, many recent informatics-based studies analyze computer provider order entry (CPOE) and clinical information system (CIS) implementation and its effects on clinician workflow. This study expands the development and use of a taxonomy to characterize distractions to clinicians and their subsequent actions in the context of CPOE/CIS use. We found a total of 75 distracting events in 406 minutes of observational data of which 32 led to interruptions and 30 led to continued multitasking. The above primary actions led to 5 tasks not completed and 4 episodes of clinician's lack of recall. Differences in the distribution of the source of distractions and primary action of the distracted clinicians may be a function of clinical setting and clinician type using the CPOE/CIS. Nine secondary actions, potentially resulting in a slip or a mistake, suggest that CPOE may necessitate different forms of safety nets than traditional clinician communication.
  Studies in health technology and informatics 02/2007; 129(Pt 2):958-62.
• Article: Interruptions during the use of a CPOE system for MICU rounds.

  Sarah Collins, Leanne Currie, Suzanne Bakken, James J Cimino
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  ABSTRACT: Clinical distractions may account for 43% of medication errors. "Silent errors" in Computer Provider Order Entry (CPOE) warrant a new perspective for interruption analysis. We developed a taxonomy of interruptions in the context of CPOE. In two hours of observed CPOE use by residents during Medical Intensive Care Unit (MICU) rounds, one distraction or interruption occurred approximately every 5 minutes and preceded 2 order entry errors. Future analysis of the proposed taxonomy in a variety of clinical settings may help to understand "silent errors" and identify possible informatics interventions to prevent such errors.
  AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium 02/2006;