TY - JOUR
T1 - A Time and Motion Analysis of Nursing Workload and Electronic Health Record Use in the Emergency Department
AU - Bakhoum, Nicole
AU - Gerhart, Christian
AU - Schremp, Emma
AU - Jeffrey, Ashley D.
AU - Anders, Shilo
AU - France, Daniel
AU - Ward, Michael J.
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/9
Y1 - 2021/9
N2 - Introduction: The use of an electronic health record may create unanticipated consequences for emergency care delivery. We sought to describe emergency department nursing task distribution and the use of the electronic health record. Methods: This was a prospective observational study of nurses in the emergency department using a time-and-motion methodology. Three trained research assistants conducted 1:1 observations between March and September 2019. Nurse tasks were classified into 6 established categories: electronic health record, direct/indirect patient care, communication, personal time, and other. Nurses’ perceived workload was assessed using the National Aeronautics and Space Administration (NASA) Task Load Index. Results: Twenty-three observations were conducted over 46 hours. Overall, nurses spent 27% of their time on electronic health record tasks, 25% on direct patient care, 17% on personal time, 15% on indirect patient care, and 6% on communication. During morning (7 AM-12 PM) and afternoon shifts (12 PM-3 PM), the use of the health record was the most commonly performed task, whereas indirect patient care was the task most performed during evening shifts (3 PM-12 PM). Using the National Aeronautics and Space Administration (NASA) Task Load Index, nurses reported an increase in mental demand and effort during afternoon shifts compared with morning shifts. Discussion: We observed that emergency nurses spent more time using the electronic health record as compared to other tasks. Increased usability of the electronic health record, particularly during high occupancy periods, may be a target for improvement.
AB - Introduction: The use of an electronic health record may create unanticipated consequences for emergency care delivery. We sought to describe emergency department nursing task distribution and the use of the electronic health record. Methods: This was a prospective observational study of nurses in the emergency department using a time-and-motion methodology. Three trained research assistants conducted 1:1 observations between March and September 2019. Nurse tasks were classified into 6 established categories: electronic health record, direct/indirect patient care, communication, personal time, and other. Nurses’ perceived workload was assessed using the National Aeronautics and Space Administration (NASA) Task Load Index. Results: Twenty-three observations were conducted over 46 hours. Overall, nurses spent 27% of their time on electronic health record tasks, 25% on direct patient care, 17% on personal time, 15% on indirect patient care, and 6% on communication. During morning (7 AM-12 PM) and afternoon shifts (12 PM-3 PM), the use of the health record was the most commonly performed task, whereas indirect patient care was the task most performed during evening shifts (3 PM-12 PM). Using the National Aeronautics and Space Administration (NASA) Task Load Index, nurses reported an increase in mental demand and effort during afternoon shifts compared with morning shifts. Discussion: We observed that emergency nurses spent more time using the electronic health record as compared to other tasks. Increased usability of the electronic health record, particularly during high occupancy periods, may be a target for improvement.
KW - Electronic health record
KW - Emergency nursing
KW - Job demands
KW - Operations
KW - Time-motion study
KW - Workload
UR - http://www.scopus.com/inward/record.url?scp=85104440967&partnerID=8YFLogxK
U2 - 10.1016/j.jen.2021.03.007
DO - 10.1016/j.jen.2021.03.007
M3 - Article
C2 - 33888334
AN - SCOPUS:85104440967
SN - 0099-1767
VL - 47
SP - 733
EP - 741
JO - Journal of Emergency Nursing
JF - Journal of Emergency Nursing
IS - 5
ER -