Factors Influencing How Intensive Care Unit Nurses Allocate Their Time

Despins, Laurel; Kim, Jung Ho; Deroche, Chelsea B; Song, Xuefei

doi:10.1177/0193945918824070

Cited by 5 publications

(13 citation statements)

References 62 publications

(88 reference statements)

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“…The SOFA score has good predictive validity for inpatient mortality with higher scores associated with higher mortality (Ferreira et al, 2001). According to the previous research done by Despins, Kim, Deroche, and Song (2019), nurses spent more time in patients' rooms with higher SOFA scores. This result is similar to another study done by (Altafin et al, 2014), who found that as SOFA scores increased, the time consumed by nursing activities increased.…”

Section: Prior Literaturementioning

confidence: 89%

“…This outcome might be explained by frequent interruptions during the out-of-room activities. ICU nurses with low experience could be interrupted more often outside the patient room compared to highly experienced nurses (Farquharson et al, 2013;Hall et al, 2010). It is also possible that ICU nurses with low experience may have less time management skills than highly experienced nurses (Pellico, Brewer, & Kovner, 2009).…”

Section: The Impact Of Nementioning

confidence: 99%

“…During the initial setup, the research team calibrated the system. Movement accuracy was assessed by research team members wearing NFER tags in the ICU (Despins et al, 2019). This system clearly showed the location of ICU nurses at a particular time.…”

Section: Nfer System Datamentioning

confidence: 99%

“…The observer recorded the start and end time of each task done by ICU nurses and took notes about any special events in an observation form (Song et al, 2017). The observation data collection form was developed from a previous pilot study in which time-motion data regarding ICU nursing activities were collected (Despins et al, 2019).…”

Section: Time-motion Study Datamentioning

confidence: 99%

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The Impact of Nurse Experience and Sequential Organ Failure Assessment on Nurses’ Workflow in an Intensive Care Unit

Kasaie

Kim

Guo

et al. 2020

Proceedings of the Human Factors and Ergonomics Society Annual

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The purpose of this study is to understand the impact of Nurse Experience (NE) and Sequential Organ Failure Assessment (SOFA) on nurses’ workflow and process time in an Intensive Care Unit (ICU). In this study, a combination of data from the time-motion study observations, ICU nurses’ Real-Time Location System (RTLS), and the Real-Time Measurement System (RTMS) data were used to develop multiple Hierarchical Task Analysis (HTA) charts. HTA chart helped us to identify the ICU nurses’ workflow patterns. The results showed that ICU nurses spent over 47% of their time on performing primary care (in-room activities) and 25% on out-of-room activities. Furthermore, NE levels and SOFA scores had significant impacts on the average process time of nurse handoff, in-room Electronic Medical Record (EMR) charting, and the workflow patterns of out-of-room activities and out-of-room EMR usage. The outcomes of this study will provide a detailed workflow of ICU nurses and might help nurse managers to conduct a better strategy for improving ICU nurse’s workflow.

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Section: Prior Literaturementioning

confidence: 89%

Section: The Impact Of Nementioning

confidence: 99%

Section: Nfer System Datamentioning

confidence: 99%

Section: Time-motion Study Datamentioning

confidence: 99%

See 2 more Smart Citations

The Impact of Nurse Experience and Sequential Organ Failure Assessment on Nurses’ Workflow in an Intensive Care Unit

Kasaie

Kim

Guo

et al. 2020

Proceedings of the Human Factors and Ergonomics Society Annual

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“…Working in an intensive care unit is a considerable source of pressure and psycho‐social stress because of the lack of natural lighting, excessive noise, the large number of professionals and clinical equipment, high patient mortality, the lack of tangible results of the care provided by nurses and the constant need for adequate decision‐making (Bahadori et al, 2014). These factors, associated with the characteristics of patients in critical condition and the workload, can negatively impact nurses (Despins et al, 2019; Myny et al, 2011; Towell et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Nursing workload assessment in an intensive care unit: A 5‐year retrospective analysis

Simões

Sá‐Couto

Simões

et al. 2021

Journal of Clinical Nursing

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Aims To study the correlation between the workload of intensive care nursing teams and the sociodemographic, anthropometric and clinical characteristics of patients in critical condition in a Portuguese Intensive Care Unit (ICU) during a 5‐year period. Background Currently, indices of nursing workload quantification are one of the resources used for planning and evaluating ICUs. Evidence shows that there are several factors related to critical patients and their hospitalisation which potentially influence the nursing workload. Design Retrospective cohort analysis of a health record database from adult patients admitted to a Portuguese ICU between 1 January 2015–31 December 2019. Methods Simplified Therapeutic Intervention Scoring System (TISS‐28) scores of 730 adult patients. Three TISS‐28 assessments were considered: first assessment, last assessment and average. The STROBE guidelines were used in reporting this study. Results The TISS‐28 has an average of 34.2 ± 6.9 points at admission, which is considered a high nursing workload. A somewhat lower result was found for the discharge and average assessments. It shows that basic activities accounted for the highest percentage of time spent (38.0%), followed by the cardiovascular support category (26.5%). The TISS‐28 shows consistent results throughout the study period, despite a small trend reduction in the last 2 years. Conclusions Lower workloads were found for age ≤44 years and with a shorter length of stay. Higher workload was more probable in patients classified in Cullen Class IV (OR = 2.5) and with a normal to higher weight percentile (OR = 1.9 and 1.5, respectively). Relevance to clinical practice Knowledge of the factors influencing the nursing workload facilitates the implementation of rules to improve performance in nursing interventions, based on the redefinition of care priorities, increased productivity, human resources management and reduction of additional costs to the organisation, related to possible adverse events, among others.

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Using event logs to observe interactions with electronic health records: an updated scoping review shows increasing use of vendor-derived measures

Rule

Melnick

Apathy

2022

Journal of the American Medical Informatics Association

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Objective The aim of this article is to compare the aims, measures, methods, limitations, and scope of studies that employ vendor-derived and investigator-derived measures of electronic health record (EHR) use, and to assess measure consistency across studies. Materials and Methods We searched PubMed for articles published between July 2019 and December 2021 that employed measures of EHR use derived from EHR event logs. We coded the aims, measures, methods, limitations, and scope of each article and compared articles employing vendor-derived and investigator-derived measures. Results One hundred and two articles met inclusion criteria; 40 employed vendor-derived measures, 61 employed investigator-derived measures, and 1 employed both. Studies employing vendor-derived measures were more likely than those employing investigator-derived measures to observe EHR use only in ambulatory settings (83% vs 48%, P = .002) and only by physicians or advanced practice providers (100% vs 54% of studies, P < .001). Studies employing vendor-derived measures were also more likely to measure durations of EHR use (P < .001 for 6 different activities), but definitions of measures such as time outside scheduled hours varied widely. Eight articles reported measure validation. The reported limitations of vendor-derived measures included measure transparency and availability for certain clinical settings and roles. Discussion Vendor-derived measures are increasingly used to study EHR use, but only by certain clinical roles. Although poorly validated and variously defined, both vendor- and investigator-derived measures of EHR time are widely reported. Conclusion The number of studies using event logs to observe EHR use continues to grow, but with inconsistent measure definitions and significant differences between studies that employ vendor-derived and investigator-derived measures.

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Factors Influencing How Intensive Care Unit Nurses Allocate Their Time

Cited by 5 publications

References 62 publications

The Impact of Nurse Experience and Sequential Organ Failure Assessment on Nurses’ Workflow in an Intensive Care Unit

The Impact of Nurse Experience and Sequential Organ Failure Assessment on Nurses’ Workflow in an Intensive Care Unit

Nursing workload assessment in an intensive care unit: A 5‐year retrospective analysis

Using event logs to observe interactions with electronic health records: an updated scoping review shows increasing use of vendor-derived measures

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