This study aimed to compare between electronic medication administration records and paper-based records in the nursing time spent on various activities in a medication round and the medicationadministration processes followed by nurses in an Australian residential aged care home. It also aimedto identify the benefits and unintended adverse consequences of using the electronic medication admin-istration records.Methods: Time-motion observation, taking of field notes, informal conversation and document reviewwere used to collect data in two units of a residential aged care home. Each unit had one nurse admin-ister medication. Seven nurses were observed over 12 morning shifts. Unit 1 used electronic medicationadministration records and Unit 2 used paper-based records.Results: No significant difference between the two units was found in the nursing time spent on variousactivities in a medication round, including documentation, verbal communication, medication adminis-tration, infection control and transit.Comparison of the medication administration processes between the electronic and paper-basedmedication administration records identified a procedural problem which violated the organization'sdocumentation requirement. This problem was documenting before providing medication to a residentwhen using the paper-based records. It was not observed with the electronic medication administrationrecords.Benefits of introducing the electronic medication administration records included improving nurses'compliance with documentation requirements, freedom from the error of signing twice, reducing thepossibility of forgetting to medicate a resident, facilitating nurses to record the time of medicationadministration to a resident and increasing documentation space. Unintended adverse consequencesof introducing the electronic medication administration records included inadequate information aboutresidents, late addition of a new resident's medication profile in the records and nurses' forgetting tomedicate a resident due to power outage of the portable device.Conclusions: The electronic medication administration records may not change nursing time spent onvarious activities in a medication round or substantially alter the medication administration processes,but can generate both benefits and unintended adverse consequences. Future research may investigatewhether and how the adverse consequences can be prevented.

Background Unhealthy alcohol use (UAU) is one of the major causes of preventable morbidity, mortality, and associated behavioral risks worldwide. Although mobile health (mHealth) interventions can provide consumers with an effective means for self-control of UAU in a timely, ubiquitous, and cost-effective manner, to date, there is a lack of understanding about different health outcomes brought by such interventions. The core components of these interventions are also unclear. Objective This study aimed to systematically review and synthesize the research evidence about the efficacy of mHealth interventions on various health outcomes for consumer self-control of UAU and to identify the core components to achieve these outcomes. Methods We systematically searched 7 electronic interdisciplinary databases: Scopus, PubMed, PubMed Central, CINAHL Plus with full text, MEDLINE with full text, PsycINFO, and PsycARTICLES. Search terms and Medical Subject Headings “mHealth,” “text message,” “SMS,” “App,” “IVR,” “self-control,” “self-regulation,” “alcohol*,” and “intervention” were used individually or in combination to identify peer-reviewed publications in English from 2008 to 2017. We screened titles and abstracts and assessed full-text papers as per inclusion and exclusion criteria. Data were extracted from the included papers according to the Consolidated Standards of Reporting Trials-EHEALTH checklist (V 1.6.1) by 2 authors independently. Data quality was assessed by the Mixed Methods Appraisal Tool. Data synthesis and analyses were conducted following the procedures for qualitative content analysis. Statistical testing was also conducted to test differences among groups of studies. Results In total, 19 studies were included in the review. Of these 19 studies, 12 (63%) mHealth interventions brought significant positive outcomes in improving participants’ health as measured by behavioral (n=11), physiological (n=1), and cognitive indicators (n=1). No significant health outcome was reported in 6 studies (6/19, 32%). Surprisingly, a significant negative outcome was reported for the male participants in the intervention arm in 1 study (1/19, 5%), but no change was found for the female participants. In total, 5 core components reported in the mHealth interventions for consumer self-control of UAU were context, theoretical base, delivery mode, content, and implementation procedure. However, sound evidence is yet to be generated about the role of each component for mHealth success. The health outcomes were similar regardless of types of UAU, deployment setting, with or without nonmobile cointervention, and with or without theory. Conclusions Most studies reported mHealth interventions for self-control of UAU appeared to be improving behavior, especially the ones delivered by short message service and interactive voice response systems. Further studies are needed to gather sound evidence about th...

BackgroundThe aim of the study is to describe the work pattern of personal care workers (PCWs) in nursing homes. This knowledge is important for staff performance appraisal, task allocation and scheduling. It will also support funding allocation based on activities.MethodsA time-motion study was conducted in 2010 at two Australian nursing homes. The observation at Site 1 was between the hours of 7:00 and 14:00 or 15:00 for 14 days. One PCW was observed on each day. The observation at Site 2 was from 10:00 to 17:00 for 16 days. One PCW working on a morning shift and another one working on an afternoon shift were observed on each day. Fifty-eight work activities done by PCWs were grouped into eight categories. Activity time, frequency, duration and the switch between two consecutive activities were used as measurements to describe the work pattern.ResultsPersonal care workers spent about 70.0% of their time on four types of activities consistently at both sites: direct care (30.7%), indirect care (17.6%), infection control (6.4%) and staff break (15.2%). Oral communication was the most frequently observed activity. It could occur independently or concurrently with other activities. At Site 2, PCWs spent significantly more time than their counterparts at Site 1 on oral communication (Site 1: 47.3% vs. Site 2: 63.5%, P = 0.003), transit (Site 1: 3.4% vs. Site 2: 5.5%, P < 0.001) and others (Site 1: 0.5% vs. Site 2: 1.8%, P < 0.001). They spent less time on documentation (Site 1: 4.1% vs. Site 2: 2.3%, P < 0.001). More than two-thirds of the observed activities had a very short duration (1 minute or less). Personal care workers frequently switched within or between oral communication, direct and indirect care activities.ConclusionsAt both nursing homes, direct care, indirect care, infection control and staff break occupied the major part of a PCW’s work, however oral communication was the most time consuming activity. Personal care workers frequently switched between activities, suggesting that looking after the elderly in nursing homes is a busy and demanding job.

Aim To investigate nursing work patterns in a neurology department in a Chinese hospital. Background Knowledge of nursing work patterns is important for nursing management and work design, and for the evaluation of organizational process change associated with the introduction of an innovation. Methods A time‐and‐motion method was used to observe 14 registered nurses’ (RNs’) work patterns in a neurology department in a Chinese hospital. Results There were 147 hr of observation. Overall, the most time‐consuming activities were verbal communication (28.5%) and documentation (28.3%), followed by indirect care (14.6%) and direct care (14%). Compared to support RNs, charge RNs spent 20% more time on documentation and 11% more time on verbal communication. Two‐thirds of the observed activities had a duration of less than 40 s. Conclusions Communication, in verbal and written forms, consumed more than half of the nursing time. Conversely, nurses only spent about a quarter of their worktime on preparation for care provision and direct care provision. This reflects the significant role and resource‐consuming nature of communication to provide safe and quality care. Implications for Nursing Management Communication methods need to be enhanced to improve nursing productivity. This may be achieved through the introduction of more effective nursing documentation methods.

Objective. To examine the time, frequency and duration of each direct care activity conducted by personal carers in Australian residential aged care homes. Methods. A time-motion study was conducted to observe 46 personal carers at two high-care houses in two facilities (14 days at Site 1 and 16 days at Site 2). Twenty-three direct care activities were classified into eight categories for analysis. Results. Overall, a personal carer spent approximately 45% of their time on direct care, corresponding to 3.5 h in an 8-h daytime shift. The two sites had similar ratios of personal carers to residents, and each resident received 30 min of direct care. No significant differences between the two sites were found in the time spent on oral communication, personal hygiene and continence activities. Personal carers at Site 1 spent significantly less time on toileting and mobility activities than those at Site 2, but more time on lunch activity. Although oral communication took the longest time (2 h), it occurred concurrently with other activities (e.g. dressing) for 1.5 h. Conclusions. The findings provide information that may assist decision makers in managing the operation of highcare residential aged care facilities, such as planning for task allocation and staffing. AbstractObjective. To examine the time, frequency and duration of each direct care activity conducted by personal carers in Australian residential aged care homes.Methods. A time-motion study was conducted to observe 46 personal carers at two highcare houses in two facilities (14 days at Site 1 and 16 days at Site 2). Twenty-three direct care activities were classified into eight categories for analysis.Results. Overall, a personal carer spent approximately 45% of their time on direct care, corresponding to 3.5 h in an 8-h daytime shift. The two sites had similar ratios of personal carers to residents, and each resident received 30 min of direct care. No significant differences between the two sites were found in the time spent on oral communication, personal hygiene and continence activities. Personal carers at Site 1 spent significantly less time on toileting and mobility activities than those at Site 2, but more time on lunch activity. Although oral communication took the longest time (2 h), it occurred concurrently with other activities (e.g. dressing) for 1.5 h.Conclusions. The findings provide information that may assist decision makers in managing the operation of high-care residential aged care facilities, such as planning for task allocation and staffing.