School of Nursing, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, Georgia, United States.
School of Nursing, University of Minnesota, Twin Cities, Minnesota, United States.
Appl Clin Inform. 2024 Oct;15(5):877-888. doi: 10.1055/a-2379-7206. Epub 2024 Aug 5.
Multitasking, defined as performing two or more interventions simultaneously, increases the cognitive burden of clinicians. This may, in turn, lead to higher risk of medication and procedural errors. Time motion study (TMS) data for nurses in nursing homes revealed an extensive amount of multitasking while managing medications. Further investigation of multitasked nursing interventions will provide a foundation for optimizing medication management workflows.
Using a continuous observational TMS method, this study aimed to describe pairs of multitasked nursing interventions associated with medication management interventions, including preparing and administering medications, assessing medication effects, instructing on medications, and documenting medication administration.
An external nurse observer used 57 predefined Omaha System nursing interventions embedded within TimeCaT (version 3.9), TMS data recording software to collect observation data in a single nursing home. A total of 120 hours of time-stamped observation data from nine nurses were downloaded from TimeCaT and analyzed using descriptive and inferential statistics.
The majority (74%) of medication management interventions were multitasked, resulting in 2,003 pairs of multitasked interventions. Of the 57 Omaha System nursing interventions, 35 were involved in these multitasking pairs. When nurses multitasked, the average duration of medication preparation was longer (non-multitasked: 81 seconds; multitasked: 162 seconds, < 0.05), while the average duration of medication administration record documentation was shorter (non-multitasked: 93 seconds; multitasked: 66 seconds, < 0.05).
The findings reveal the complexity of medication management in nursing homes with numerous and diverse multitasking pairs. Findings provide a platform for in-depth study of medication management multitasking in the clinical context, and inform future efforts to create clinical and informatics solutions to optimize medication management workflow. This method may be also applied to examine medication management and multitasking in other clinical settings.
同时执行两项或多项干预措施被定义为多任务处理，这会增加临床医生的认知负担。这反过来又可能导致更高的药物和程序错误风险。养老院护士的时间运动研究 (TMS) 数据显示，在管理药物时，大量进行多任务处理。进一步研究多任务护理干预措施将为优化药物管理工作流程提供基础。
本研究采用连续观察 TMS 方法，旨在描述与药物管理干预措施相关的多任务护理干预措施对，包括准备和给药、评估药物效果、指导用药和记录药物管理。
一名外部护士观察员使用 57 项预定义的 Omaha 系统护理干预措施嵌入 TimeCat（版本 3.9）中，TMS 数据记录软件，在一家养老院收集观察数据。从 TimeCat 下载了来自 9 名护士的总计 120 小时带时间戳的观察数据，并使用描述性和推断性统计进行分析。
大多数（74%）药物管理干预措施是多任务处理，导致 2003 对多任务处理干预措施。在 57 项 Omaha 系统护理干预措施中，有 35 项涉及这些多任务处理对。当护士多任务处理时，药物准备的平均持续时间更长（非多任务处理：81 秒；多任务处理：162 秒，<0.05），而药物管理记录文档的平均持续时间更短（非多任务处理：93 秒；多任务处理：66 秒，<0.05）。
研究结果揭示了养老院药物管理的复杂性，存在众多且多样化的药物管理多任务处理对。研究结果为深入研究临床背景下的药物管理多任务处理提供了平台，并为未来努力创造临床和信息学解决方案以优化药物管理工作流程提供了信息。这种方法也可以应用于检查其他临床环境中的药物管理和多任务处理。
