Hordern Antonia, Callen Joanne, Gibson Kathryn, Robertson Louise, Li Ling, Hains Isla M, Westbrook Johanna I
Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, University of New South Wales, Sydney, Australia.
Stud Health Technol Inform. 2012;178:71-6.
Medication monitoring of ambulatory rheumatology patients on Disease Modifying Anti-Rheumatic Drugs (DMARDS) is time consuming and complex, with possibilities for error. Electronic systems have the potential to improve the process. The aim of this study was to evaluate the impact of an electronic Drug Monitoring System (eDMS) on the time nurses' spent on clinical documentation associated with monitoring. The study was conducted with all nurses (n=4) in the Rheumatology Department of a large metropolitan Australian teaching hospital. The eDMS was designed as a module of the Hospital Clinical Information System (HCIS) to assist clinicians in monitoring rheumatology patients on DMARDS. Timing data were collected using a modified time and motion work measurement technique using software on a handheld computer. Data included the time nurses spent on documentation regarding medication monitoring before and after the implementation of the eDMS. Results showed that following implementation of the eDMS nurses spent significantly less time documenting medication monitoring information (13.6% to 7.2%, P<.0001). The cumbersome paper-based Drug Monitoring Patient List was replaced entirely by the eDMS. Consequently, there was a significant decrease in the time nurses spent using the HCIS (13.01% to 2.8%, p<.0001) for monitoring and the use of loose-leaf paper also decreased (7.6% to 5.0%, p = 0.002). The eDMS made the process of drug monitoring quicker and simpler for nurses and thus permitted them to increase their time spent in direct patient care.
对使用改善病情抗风湿药（DMARDs）的门诊风湿病患者进行药物监测既耗时又复杂，且存在出错的可能性。电子系统有潜力改善这一过程。本研究的目的是评估电子药物监测系统（eDMS）对护士用于与监测相关临床记录的时间的影响。该研究在澳大利亚一家大型都市教学医院的风湿病科的所有护士（n = 4）中进行。eDMS被设计为医院临床信息系统（HCIS）的一个模块，以协助临床医生监测使用DMARDs的风湿病患者。使用手持计算机上的软件，采用改良的时间与动作工作测量技术收集时间数据。数据包括在实施eDMS前后护士用于药物监测记录的时间。结果显示，实施eDMS后，护士记录药物监测信息的时间显著减少（从13.6%降至7.2%，P<0.0001）。繁琐的纸质药物监测患者清单完全被eDMS取代。因此，护士使用HCIS进行监测的时间显著减少（从13.01%降至2.8%，p<0.0001），活页纸的使用也减少了（从7.6%降至5.0%，p = 0.002）。eDMS使护士的药物监测过程更快、更简单，从而使他们能够增加直接护理患者的时间。
