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Table 1 Specifications for an electronic vital sign documentation system developed following analysis of nursing practice

From: SEND: a system for electronic notification and documentation of vital sign observations

Specification Derived requirement Implementation
Reliable and accurate user and patient identification with minimal reliance on supporting systems and infrastructure Identification of the patient using demographics encoded within the PDF417 barcode on the patient’s ID wristband Hardware: 2D barcode scanner
Software: Allow patient identification through 1D or 2D barcode wristbands
Minimise the time to enter and access data • Minimise time for device wake/login Hardware: capable of running one of the mobile operating systems (iOS, Android, Windows 8)
• Real-time data entry validation Software: Minimise requests to server by building highly-dynamic web pages, and completing rudimentary data processing on the client
Encourage contemporaneous data entry at the bedside by minimising physical workload or the possibility of items needed to complete the task being unavailable [19, 20]. Ensure that all equipment required for the task is co-located Hardware: Mount the screen and barcode scanner on the same stand as the monitoring equipment
Support users in applying their clinical judgement by minimising the physical and cognitive workload. Attempt to avoid the unintended consequence of users supressing their own judgement in favour of the interpretation provided by the system [21]. • Staff should be able to see previous vital signs at the time of data entry to facilitate interpretation Hardware: Sufficiently large screen to enable a chart view that is easy to interpret.
• All vital signs in an observation set should be visible without requiring the user to scroll
• Data should be readable by users who may not have perfect visual acuity.
• Wherever possible, data should be presented graphically [22]
The physical and mental workload to review data should be minimised • Data should be viewable on computing devices used for clinical data access within the Oxford University Hospitals Trust as well as accessible within the Oxford University Hospitals Trust’s Electronic Patient Record (Cerner) Software: Web-based application that works on all platforms and can be embedded within third part systems.
• The data should be displayed in the same format wherever possible
All hardware and software must Adhere to the local hospital trust policies   Hardware: Must comply with infection control, and health and safety regulations
Software: Data must be stored securely