Using a Task Analysis to Describe Nursing Work in Acute Care Patient Environments

Battisto, Dina; Pak, Richard; Wood, Melissa A. Vander; Pilcher, June J.

doi:10.1097/nna.0b013e3181c1806d

Cited by 39 publications

(33 citation statements)

References 25 publications

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“…Measures of frequency, duration, and sequence of tasks and task categories were quantified in a number of studies (Battisto, Pak, Vander Wood, & Pilcher, 2009; Hendrich, Chow, Skierczynski, & Lu, 2008; Hendrickson, Doddato, & Kovner, 1990). Battisto et al (2009) used job task analysis to measure the frequency of nine nurse activities in medical–surgical units at a large community hospital. Nurses spent 25% of their time on documentation and 55% of their time on direct patient care.…”

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confidence: 99%

The Work of Adult and Pediatric Intensive Care Unit Nurses

et al. 2013

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Background Researchers have used various methods to describe and quantify the work of nurses. Many of these studies were focused on nursing in general care settings; therefore, less is known about the unique work nurses perform in intensive care units (ICUs). Objectives The aim of this study was to observe adult and pediatric ICU nurses in order to quantify and compare the duration and frequency of nursing tasks across four ICUs as well as within two discrete workflows: nurse handoffs at shift change and patient interdisciplinary rounds. Methods A behavioral task analysis of adult and pediatric nurses was used to allow unobtrusive, real-time observation. A total of 147 hours of observation were conducted in an adult medical-surgical, a cardiac, a pediatric, and a neonatal ICU at one rural, tertiary care community teaching hospital. Results Over 75% of ICU nurses’ time was spent on patient care activities. Approximately 50% of this time was spent on direct patient care, over 20% on care coordination, 28% on nonpatient care, and approximately 2% on indirect patient care activities. Variations were observed between units; for example, nurses in the two adult units spent more time using monitors and devices. A high rate and variety of tasks were also observed: Nurses performed about 125 activities per hour, averaging a switch between tasks every 29 seconds. Discussion This study provides useful information about how nurses spend their time in various ICUs. The methodology can be used in future research to examine changes in work related to, for example, implementation of health information technology.

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confidence: 99%

The Work of Adult and Pediatric Intensive Care Unit Nurses

et al. 2013

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“…The majority of studies (50 or 86%) involved various types of healthcare workers, such as nurses in rehabilitation facilities (Yassi et al, 2004) or hospitals (Battisto, Pak, Vander Wood, & Pilcher, 2009; Capuano, Bokovoy, Halkins, & Hitchings, 2004); this confirms the occupational focus of HFE research in health care. Twenty studies (34%) involved patients and three studies (5%) involved families.…”

Section: Resultsmentioning

confidence: 57%

“…The next major category includes studies about the work of nurses, physicians and other healthcare workers (e.g., optometrist, home care worker) (20%). For example, Battisto et al (2009) used multiple methods to describe the work of nurses in medical-surgical hospital units. About 46 hours of observation provided information on the frequency of nurses’ activities, their location and any information about task errors.…”

Section: Resultsmentioning

confidence: 99%

A systematic review of mixed methods research on human factors and ergonomics in health care

Carayon

Kianfar

et al. 2015

Applied Ergonomics

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This systematic literature review provides information on the use of mixed methods research in human factors and ergonomics (HFE) research in health care. Using the PRISMA methodology, we searched four databases (PubMed, PsycInfo, Web of Science, and Engineering Village) for studies that met the following inclusion criteria: (1) field study in health care, (2) mixing of qualitative and quantitative data, (3) HFE issues, and (4) empirical evidence. Using an iterative and collaborative process supported by a structured data collection form, the six authors identified a total of 58 studies that primarily address HFE issues in health information technology (e.g., usability) and in the work of healthcare workers. About two-thirds of the mixed methods studies used the convergent parallel study design where quantitative and qualitative data were collected simultaneously. A variety of methods were used for collecting data, including interview, survey and observation. The most frequent combination involved interview for qualitative data and survey for quantitative data. The use of mixed methods in healthcare HFE research has increased over time. However, increasing attention should be paid to the formal literature on mixed methods research to enhance the depth and breadth of this research.

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“…21 Battisto et al used a task list to describe nursing work in the hospital setting to inform the redesign of inpatient rooms and care areas to improve nursing productivity. 19 Our task list, similarly, should be useful in similar ways.…”

Section: Discussionmentioning

confidence: 99%

“…This procedure could then be used to better understand time demands. 19 Last this task list, although developed and validated from a large, diverse pool of physicianepatient visits, may not be a complete listing of all physician tasks. But we believe it represents the majority of tasks.…”

Section: Discussionmentioning

confidence: 99%

Development of a primary care physician task list to evaluate clinic visit workflow: Table 1

et al. 2011

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Background Interventions designed to improve the delivery of primary care, including Patient-Centered Medical Homes and electronic health records, require an understanding of clinical workflow to be successfully implemented. However, there is a lack of tools to describe and study primary care physician workflow. We developed a comprehensive list of primary care physician tasks that occur during a face-to-face patient visit. Methods A validated list of tasks performed by primary care physicians during patient clinic visits was developed from a secondary data analysis of observation data from two studies evaluating primary care workflow. Thirty primary care physicians participated from a convenience sample of 17 internal medicine and family medicine clinics in Wisconsin and Iowa across rural and urban settings and community and academic settings. Results The final task list has 12 major tasks, 189 subtasks, and 191 total tasks. The major tasks are: Enter Room, Gather Information from Patient, Review Patient Information, Document Patient Information, Perform, Recommend / Discuss Treatment Options, Look Up, Order, Communicate, Print / Give Patient (advice, instructions), Appointment Wrap-up, and Leave Room. Additional subcodes note use of paper or EHR and the presence of a caregiver or medical student. Conclusions The task list presented here is a tool that will help clinics study their workflows so they can plan for changes that will take place because of EHR implementation and/or transformation to a patient centered medical home.

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Using a Task Analysis to Describe Nursing Work in Acute Care Patient Environments

Cited by 39 publications

References 25 publications

The Work of Adult and Pediatric Intensive Care Unit Nurses

The Work of Adult and Pediatric Intensive Care Unit Nurses

A systematic review of mixed methods research on human factors and ergonomics in health care

Development of a primary care physician task list to evaluate clinic visit workflow: Table 1

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