Changes in intensive care unit nurse task activity after installation of a third-generation intensive care unit information system.

Wong DH, Gallegos Y, Weinger MB, Clack S, Slagle J, Anderson CT
Crit Care Med. 2003 31 (10): 2488-94

PMID: 14530756 · DOI:10.1097/01.CCM.0000089637.53301.EF

UNLABELLED - OBJECTIVE To determine the percentage of time that intensive care unit (ICU) nurses spend on documentation and other nursing activities before and after installation of a third-generation ICU information system.

DESIGN - Prospective data collection using real-time time-motion analysis, before and after installation of the ICU information system.

SETTING - A ten-bed surgical ICU at a Veterans Affairs medical center.

SUBJECTS - ICU nurses.

INTERVENTIONS - Installation of a third-generation ICU information system.

MEASUREMENTS AND MAIN RESULTS - Ten ICU nurses were studied before and after installation of the ICU information system. Each ICU nurse's activities and tasks, during 4-hr observation periods, were categorized in real-time by a nurse observer and recorded in a laptop computer. Each recorded task was automatically time-stamped and logged into a data file. The percentage of time spent on documentation decreased from 35.1 +/- 8.3% to 24.2 +/- 7.6% (p =.025) after the ICU information system was installed. The percentage of time providing direct patient care increased from 31.3 +/- 9.2% to 40.1 +/- 11.7% (p =.085). The percentage of time doing patient assessment, a direct patient care task, increased from 4.0 +/- 4.7% to 9.4 +/- 4.4% (p =.001).

CONCLUSIONS - Installation of a third-generation ICU information system decreased the percentage of time ICU nurses spent on documentation by >30%. Almost half of the time saved on documentation was spent on patient assessment, a direct patient care task.

MeSH Terms (7)

Hospitals, Veterans Humans Information Systems Intensive Care Units Nursing Care Prospective Studies Time Factors

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