Holmqvist Malin, Ekstedt Mirjam, Walter Scott R, Lehnbom Elin C
Malin Holmqvist, MScPharm, is a Clinical Pharmacist, County Council of Jonkoping, Sweden. Mirjam Ekstedt, PhD, is a Professor, School of Health and Caring Sciences, Linnaeus University, Kalmar Sweden, and Researcher, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden. Scott R. Walter, PhD, is a Research Fellow in Applied Biostatistics, Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia. Elin C. Lehnbom, PhD, is an Associate Professor, Department of Pharmacy, Faculty of Health Science, UiT The Arctic University of Norway, Tromsø, Norway, and Researcher, School of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.
Home Healthc Now. 2018 Jul/Aug;36(4):238-246. doi: 10.1097/NHH.0000000000000671.
The objective of this observational time and motion study was to increase our understanding of how nurses in home healthcare currently distribute their work time with a focus on the medication management process. The research was conducted in four municipalities in the southern part of Sweden. Participants were nurses working in home healthcare. The study measured proportion of time, comparison of proportions of time, proportion of time spent multitasking, and rate of interruptions per hour. Of total observed time, 20.4% was spent on medication management and of these tasks the highest proportion of time was spent on communications and dispensing medications. Nurses in nursing homes spent more time (23.0% vs. 17.4%, p = 0.001) on medication management than nurses in private homes. Nurses spent 47.9% of their time completing tasks with someone else, including patients, but had minimal interaction with prescribers. We observed a rate of 1.2 (95% CI 1.1-1.4) interruptions per hour on average and 30% of all interruptions occurred during medication management tasks. Nurses spent 3.7% of their time multitasking. Interruptions while performing medication-related tasks were common, as well as multitasking. Causes and consequences of the results need to be addressed in order to improve the safety of medication management for patients receiving municipality-based home care.
这项观察性时间与动作研究的目的是加深我们对家庭医疗保健护士目前如何分配工作时间的理解，重点是药物管理过程。该研究在瑞典南部的四个直辖市进行。参与者是从事家庭医疗保健工作的护士。该研究测量了时间比例、时间比例比较、多任务处理所花费的时间比例以及每小时的中断率。在总观察时间中，20.4%用于药物管理，其中用于沟通和分发药物的时间比例最高。养老院的护士在药物管理上花费的时间（23.0%对17.4%，p = 0.001）比私人住宅中的护士更多。护士47.9%的时间用于与他人（包括患者）一起完成任务，但与开处方者的互动很少。我们观察到平均每小时中断率为1.2（95%置信区间1.1 - 1.4），所有中断中有30%发生在药物管理任务期间。护士3.7%的时间用于多任务处理。执行与药物相关任务时的中断以及多任务处理都很常见。为了提高接受市政家庭护理患者的药物管理安全性，需要解决这些结果的原因和后果。
