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New research · Pulmonology & Critical Care
Applied clinical informatics · 22h
Randomized trialApplied clinical informatics · 2026

Spatially Integrated Electronic Health Record Prototype Improves Usability and Reduces Cognitive Load for Intensive Care Nurses: A Randomized Crossover Trial.

Lee Taylor-Vaughan, Morrison W Helena, Graciela E Silva Torres … Sheila M Gephart
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Pulmonology & Critical CareRandomized trial

Spatial electronic health record prototype reduces intensive care nurses' cognitive workload.

Spatially Integrated Electronic Health Record Prototype Improves Usability and Reduces Cognitive Load for Intensive Care Nurses: A Randomized Crossover Trial.

Lee Taylor-Vaughan et al. · Applied clinical informatics · 2026
Purpose

This study evaluated the effect of a Spatial Awareness Integrated Electronic Health Record (SAI-EHR) prototype on efficiency, usability, and cognitive workload among intensive care nurses performing standardized documentation tasks, compared with a traditional linear flowsheet-style interface (LID-EHR).

Methods

A randomized, two-period crossover simulation was conducted with 36 intensive care unit (ICU) nurses who completed two standardized scenarios.

n = 36 intensive care unit (ICU) nurses
Results
lower
intensive care nurses' mental effort was lower with the new EHR
n = 36 intensive care unit (ICU) nurses
More results

SAI-EHR reduced documentation time by 177 seconds (27% faster; p < 0.001, d = 0.88) per task.

TAM-BI was substantially higher for SAI-EHR (25.5% increase; Δ = 0.96; 95% confidence interval [CI]: 0.55-1.36; p < 0.001, d = 0.72).

Lower cognitive workload was associated with a stronger intention to adopt ( r = -0.64; p < 0.001).

“
Conclusion · 1 of 2

An SAI-EHR prototype mirroring ICU room layout enabled faster, more accurate documentation with lower perceived workload than a linear flowsheet interface.

Conclusion · 2 of 2

Stated intention to adopt was higher and inversely associated with workload; differences in SUS and TAM perceived usefulness scores favored the spatial interface but did not reach statistical significance in this sample.

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