Thursday, July 12, 2007
This presentation is part of : EBN Implementation
A time and motion study of nursing staff in the performance of medication administration
Erika Blake Sharpnack Elganzouri, RN, MSN, MBA1, Cynthia A. Standish, RNC, BSN1, and Ida Androwich, RNC, PhD, FAAN2. (1) Graduate School of Nursing, Loyola University Chicago, Maywood, IL, USA, (2) Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, IL, USA
Learning Objective #1: better understand the medication administration process and interruptions and distractions that occur from a systems perspective.
Learning Objective #2: quantify nursing effort (time and motion) for medication administration to increase efficiency and improve workflow.

Errors can occur throughout the process of ordering a medicine, dispensing, retrieving, and administrating process.  Safety measures have been implemented for physicians prescribing medication and pharmacists dispensing medication through MARs and CPOE.  However, there is no safety net for nursing. Bar coding can offer that safety net and verify the five rights of medication administration. Prior to implementation of a bar coding medication system (BCMA), it is important to understand nursing work flow during the medication administration process to best determine how this solution can be an effective means of medication administration. 
The goal of this descriptive observational study was to develop and test a method for assessing the nursing effort required in the medicine administration process and to better understand nursing work flow. This study of nursing effort (time and motion) was conducted at three institutions; a rural community hospital, an urban community hospital, and an academic health center.  Data were collected in each hospital in medical/ surgical units over 72 hour periods (Total N=630 unique medication passes by over 90 nurses). For this study, the medication administration process was divided into four distinct time periods; medication preparation, retrieval, administration, and documentation. Inter rater reliability for data collectors was assessed at 99.6%.  Nurses also wore pedometers during the study. The results of the study to be reported include: timing of each phase of the medication administration process, frequency and sources of interruptions/distractions during the medication administration process, nursing effort (number of steps), identified workflow issues and recommendations for changes. This study will be the largest identified nursing time and motion research conducted to date, and will provide improved understanding of the medication administration process