Helgi Thor Ingason

The development and piloting of electronic standardized measures on nursing work: combining engineering and nursing knowledge.

AIMS This paper describes the development and piloting of electronic standardized measures on nursing work (e-SMNW) for rich data gathering on the work and work environment of registered nurses (RNs) and practical nurses (PNs). BACKGROUND Efficient and valid methods are needed to measure nursing work to enhance the optimal use of the nursing workforce for safe patient care. METHODS The study combined human factors engineering (HFE) and nursing knowledge to develop electronic standardized measures for observational studies on nursing work in acute care. RESULTS The work and work environment of RNs and PNs in acute care medical and surgical inpatient units was successfully measured using e-SMNW. With predetermined items of work activities and influencing factors in the work of nurses, and full use of computer technology, multi-layered rich standardized data were gathered, analysed and displayed. CONCLUSIONS The combination of nursing knowledge, HFE and computer technology enables observational data collection for a rich picture of the complex work of nursing. IMPLICATIONS FOR NURSING MANAGEMENT Information collected by standardized and multi-layered measures makes it easier to identify potential improvements, with regard to influencing factors and management of the work and work environment of nurses. Further use of computer technology in health services research is encouraged.

What Happens during Nurses' Medication Work in Acute Care: An Observational Study from One Hospital in Iceland

The importance of nurses being able to carry out medication work uninterrupted is increasingly identified and emphasized. However, the actual conditions during medication work of nurses are less known. This paper sheds light on what happens during medication work of nurses in acute care. An observational study was carried out in four inpatient university hospital units. Structured quantifiable measures were collected on handheld computers as well as qualitative field notes recorded on digital recorders. Data were gathered during 8 whole shifts. Participants used 17% of their working time for medication related work. On average their work during that time was disrupted 11.4 times per shift. The most frequent influencing factor the nurses encountered was non-self initiated communication by a coworker during medication preparation. Nurses spend a substantial part of their working time on medication preparation and administration; work which requires their full attention. However, their attention is frequently shifted between work activities and factors influencing their work, increasing the risk of medication errors. Findings indicate an urgent need to minimize the risks and the financial costs due to disruptions caused by untimely communication, lack of information and material resources in place during medication related work of nurses in acute care.