Please write a 250 word summary over the article: \"A 36-Hospital Time and Motio
ID: 393070 • Letter: P
Question
Please write a 250 word summary over the article: "A 36-Hospital Time and Motion Study: How Do Medical-Surgical Nurses Spend Their Time?"
Context: Nurses are the primary hospital caregivers. Increasing the efficiency and effectiveness of nursing care is essential to hospital function and the delivery of safe patient care.
Objective: We undertook a time and motion study to document how nurses spend their time. The goal was to identify drivers of inefficiency in nursing work processes and nursing unit design.
Design: Nurses from 36 medical-surgical units were invited to participate in research protocols designed to assess how nurses spend their time, nurse location and movement, and nurse physiologic response.
Main Outcome Measures: Nurses' time was divided into categories of activities (nursing practice, unit-related functions, nonclinical activities, and waste) and locations (patient room, nurse station, on-unit, off-unit). Total distance traveled and energy expenditure were assessed. Distance traveled was evaluated across types of unit design.
Results: A total of 767 nurses participated. More than three-quarters of all reported time was devoted to nursing practice. Three subcategories accounted for most of nursing practice time: documentation (35.3%; 147.5 minutes), medication administration (17.2%; 72 minutes), and care coordination (20.6%; 86 minutes). Patient care activities accounted for 19.3% (81 minutes) of nursing practice time, and only 7.2% (31 minutes) of nursing practice time was considered to be used for patient assessment and reading of vital signs.
Conclusion: The time and motion study identified three main targets for improving the efficiency of nursing care: documentation, medication administration, and care coordination. Changes in technology, work processes, and unit organization and design may allow for substantial improvements in the use of nurses' time and the safe delivery of care.
Explanation / Answer
The article begins with a general context of nurses as the primary caregivers in a hospital ensuring safe delivery of patient care. The need and importance of increasing the efficiency of nursing care to the functioning of the hospital are highlighted in the article. The main objective of the study is to undertake a time and motion study to assess and document the time spent by the nurses in a hospital. The article aims to identify the inefficiencies in the work process and unit design of nursing. The study was conducted across 36 medical-surgical units to assess the time spent by nurses. A total of 767 nurses participated in the time and motion study.
The main outcome measures of assessing the time spent by nurses were grouped under two broad categories of activities and locations in assessing the energy expenditure and the total distance traveled. The activity measures include unit related functions, nursing practice, waste and non-clinical activities. The location-based measures include nurse station, patient room, off the unit and on unit distance traveled.
The results revealed that nearly 75% of the time was spent on nursing practice. The split up of nursing practice activities is summarized as follows:
Documentation - (35.3%, 147.5 minutes)
Medication administration - (17.2%, 72 minutes)
Care coordination - (20.6%, 86 minutes)
Patient care activities – (19.3%, 81 minutes
Patient assessment and vital signs reading – (7.2%, 31 minutes)
The time and motion study concludes stating that improvements are needed in the nursing practice activities that are listed above with specific targets on the documentation, medication administration and care coordination activities. Recommendations were made to implement changes in technology, unit design, unit organization and work processes to improve the work timings of nurses and the delivery of safe care.