AHRQ Recognizes Nurses’ Unique Contributions to Diagnostic Processes

September 21, 2022 by Alec Stone MA, MPA, Former ONS Director of Government Affairs and Advocacy

Nurses bring unique but critical input to diagnostic processes in the emergency department (ED), the Agency for Healthcare Research and Quality (AHRQ) reported (https://www.ahrq.gov/sites/default/files/publications2/files/distributed-cognition-er-nurses_0.pdf) in August 2022. “Nurses have unique, valuable knowledge based not only on principles of science but also on holism and intuition,” the agency said (https://www.ahrq.gov/sites/default/files/publications2/files/distributed-cognition-er-nurses_0.pdf).

The diagnostic process traditionally involves an individual response to information (https://www.ahrq.gov/sites/default/files/publications2/files/distributed-cognition-er-nurses_0.pdf), according to AHRQ, but a distributed cogitation approach (https://www.ahrq.gov/sites/default/files/publications2/files/distributed-cognition-er-nurses_0.pdf) obtains a wide range of input, especially from nurses. Because of the risk for diagnostic error (https://www.ahrq.gov/sites/default/files/publications2/files/distributed-cognition-er-nurses_0.pdf) in EDs, the agency said that emphasizing the role of nurses through the frame of distributed cognition (https://www.ahrq.gov/sites/default/files/publications2/files/distributed-cognition-er-nurses_0.pdf) “would be a major advancement in the quest to limit harm associated with these errors.”

“Nurses are uniquely positioned to gather patient input because of the monitoring and surveillance functions that put nurses in frequent close contact with patients and allow them to see and hear things physicians do not,” AHRQ said (https://www.ahrq.gov/sites/default/files/publications2/files/distributed-cognition-er-nurses_0.pdf). “As part of the monitoring function, nurses assess trends in quantifiable physiologic parameters such as vital signs and other less perceptible manifestations of illness such as anxiety or depression.”

The agency continued (https://www.ahrq.gov/sites/default/files/publications2/files/distributed-cognition-er-nurses_0.pdf), “Nurses also play an important role in how communication affects diagnosis, such as serving as patient advocates, answering patient questions, providing support, and educating patients about their conditions. Physicians at times use language that is not easily understood by lay people, and time pressures or frequent interruptions in the ED further restrict physicians from fully engaging with each patient. Therefore, nurses often fill the gaps and translate jargon into terms the patient can comprehend.”

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