Yen Po-Yin, Kellye Marjorie, Lopetegui Marcelo, Saha Abhijoy, Loversidge Jacqueline, Chipps Esther M, Gallagher-Ford Lynn, Buck Jacalyn
Institute for Informatics, Department of Medicine, Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO.
Goldfarb School of Nursing, Barnes Jewish College, BJC Healthcare, St. Louis, MO.
AMIA Annu Symp Proc. 2018 Dec 5;2018:1137-1146. eCollection 2018.
Nurses have been required to provide more patient-centered, efficient, and cost effective care. In order to do so, they need to work at the top of their license. We conducted a time motion study to document nursing activities on communication, hands-on tasks, and locations (where activities occurred), and compared differences between different time blocks (7am-11am, 11am-3pm, and 3pm-7pm). We found that nurses spent most of their time communicating with patients and in patient rooms. Nurses also spent most of their time charting and reviewing information in EHR, mostly at the nursing station. Nurses' work was not distributed equally across a 12-hour shift. We found that greater frequency and duration in hands-on tasks occurred between 7am-11am. In addition, nurses spent approximately 10% of their time on delegable and non-nursing activities, which could be used more effectively for patient care. The study results provide evidence to assist nursing leaders to develop strategies for transforming nursing practice through re-examination of nursing work and activities, and to promote nurses working at top of license for high quality care and best outcomes. Our research also presents a novel and quantifiable method to capture data on multidimensional levels of nursing activities.
护士们被要求提供更以患者为中心、高效且具成本效益的护理。为了做到这一点，他们需要充分发挥其执业能力。我们进行了一项时间动作研究，以记录护理活动中的沟通、实际操作任务以及活动发生的地点，并比较不同时间段（上午7点至11点、上午11点至下午3点以及下午3点至晚上7点）之间的差异。我们发现，护士们大部分时间都在与患者沟通以及待在患者病房里。护士们还把大部分时间花在电子健康记录系统中记录和查看信息上，主要是在护士站。护士们的工作在12小时轮班期间分布不均。我们发现，实际操作任务的频率和时长在上午7点至11点之间更高。此外，护士们将大约10%的时间花在了可委托的非护理活动上，这些时间可更有效地用于患者护理。研究结果为护理领导者提供了证据，以帮助他们通过重新审视护理工作和活动来制定转变护理实践的策略，并促进护士充分发挥执业能力以实现高质量护理和最佳结果。我们的研究还提出了一种新颖且可量化的方法，用于在多维层面上获取护理活动数据。
