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The objective of this study was to examine handoffs and nurses\u2019 use of computerized patient summary reports in an electronic health record after computerized provider order entry (CPOE) was installed. We observed and audio taped 93 patient handoffs on 25 occasions on 5 acute care units in 2 different facilities sharing a vendor\u2019s electronic health record. We found that the computerized patient summary report and the electronic health record were minimally used during the handoff and that the existing patient summary reports did not provide adequate cognitive support for nurses. The patient summary reports were incomplete, rigid and did not offer \u201cat a glance\u201d information, or help nurses encode information. We make recommendations about a redesign of patient summary reports and technology to support the cognitive needs of nurses during handoffs at the change of shift.<\/jats:p>","DOI":"10.1177\/1460458211405809","type":"journal-article","created":{"date-parts":[[2011,9,21]],"date-time":"2011-09-21T02:26:07Z","timestamp":1316571967000},"page":"209-223","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":61,"title":["Why patient summaries in electronic health records do not provide the cognitive support necessary for nurses\u2019 handoffs on medical and surgical units: Insights from interviews and observations"],"prefix":"10.1177","volume":"17","author":[{"given":"Nancy","family":"Staggers","sequence":"first","affiliation":[{"name":"University of Maryland Baltimore, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Clark","sequence":"additional","affiliation":[{"name":"University of Utah, Salt Lake City, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacquelyn W.","family":"Blaz","sequence":"additional","affiliation":[{"name":"University of Utah, Salt Lake City, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seraphine","family":"Kapsandoy","sequence":"additional","affiliation":[{"name":"University of Utah, Salt Lake City, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2011,9,20]]},"reference":[{"key":"bibr1-1460458211405809","doi-asserted-by":"publisher","DOI":"10.1097\/NNA.0b013e3181b3b63a"},{"key":"bibr2-1460458211405809","doi-asserted-by":"publisher","DOI":"10.1016\/j.jopan.2007.06.003"},{"key":"bibr3-1460458211405809","doi-asserted-by":"publisher","DOI":"10.1097\/00005110-200411000-00010"},{"issue":"7","key":"bibr4-1460458211405809","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1097\/00005110-200507000-00004","volume":"35","author":"Potter P","year":"2005","journal-title":"J Nurs Adm"},{"key":"bibr5-1460458211405809","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0349.2008.00545.x"},{"key":"bibr6-1460458211405809","unstructured":"Wachter R. 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