A Multimodal Perspective on the Transfer of Information between Nurses in the Intensive Care Unit

Hakemuksen tiivistelmä

When an intensive care unit (ICU) nurse ends their work shift, they relay patient information to their incoming colleague in a structured handoff conversation. Communication errors in these handoffs account for one third of medical errors globally. Prior studies on nurse communication focus on individual aspects of the work, such as handoffs, registry systems, and patient communication. This means we lack a general understanding of how nurses construe and refine information about their patients during a shift – a prerequisite for understanding why communicating that information might fail. My doctoral research aims to fill this gap by providing a process-oriented understanding of information construal and communication in the ICU. This requires a multimodal approach, since this information is acquired through various ‘modes’ of expression, using medical devices, documents, and interaction with the patient. Improving our understanding of information construal and communication has potentially life-saving applications in nursing work. My thesis proposes a novel approach to understanding this complex process, developing an interdisciplinary framework that draws from linguistics, multimodal semiotics, and nursing science to capture the process of information construal involved. This approach views nurse communication as a process of dynamic knowledge construal, where each distinct observation made by the nurse contributes to the synthesis they relay to their colleague at shift end. This incremental building of knowledge is captured through structured ethnographies, collection of medical device and interface data, and analysis of the handoff conversation. These discrete data points are finally brought together in a multimodal corpus that allows for cross-referencing information between the handoff conversation and the recorded observations, highlighting the patterns of interaction present in the data.