Triangulating Technology Acceptance, Cognitive Load, and Human Factors: A Qualitative Analysis of Nursing Workflows with Multi-Vendor CCIS in PICU.

Electronic Health Records (EHRs) and Critical Care Information Systems (CCIS) are essential for data integration and patient safety. However, multi-vendor environments can introduce interface inconsistencies, increasing nurses' cognitive workload. This study qualitatively analyzed operational challenges following the implementation of a multi-vendor CCIS (Vendor A and B) in a Pediatric Intensive Care Unit. Free-text reports were examined using inductive content analysis. A total of 216 codes were identified and organized into 41 subcategories and eight overarching categories. Key findings revealed critical safety risks, including medication authentication failures and a significant unit discrepancy in NG tube depth ('cm' vs 'cmH2O'). Furthermore, the inadequacy of nursing observation masters rendered expert nursing practice "invisible" within the records. These issues highlight that safety risks arise not from a lack of standards, but from the failed migration of facility-specific master data and inadequate implementation by vendors. To ensure patient safety, it is essential for vendors to guarantee the integrity of terminology implementation and for organizations to prioritize the seamless transition of clinical expertise during system replacement.