Introduction:The In-patient Medication Order Entry System (IPMOE) was first implemented in the medical ward of Princess Margaret Hospital,Hong Kong.It was a local developed close-loop system including prescription,dis...Introduction:The In-patient Medication Order Entry System (IPMOE) was first implemented in the medical ward of Princess Margaret Hospital,Hong Kong.It was a local developed close-loop system including prescription,dispensing and administration modules.Evaluation on its impact on nursing tasks would be important for practice improvement and subsequent system enhancement.Objective:The study was conducted to quantify the nursing times across medication-associated tasks for paper-based MAR and computer-based IPMOE,including change in the tasks and time patterns before and after IPMOE implementation.Methods:This was a prospective observation study in medical wards before (Jan 2014-Jun 2014) and after (Mar 2015-Jun 2015) the implementation of IPMOE.We conducted 8-hr observation studies of individual nurses with a customized application to time various pre-categorized nursing tasks.Statistical inferences and interrupted time series analysis was performed to identify the change in the intercept and trends over time after implementation.Result:The average number of medication-related tasks was significantly reduced from 61.07 to 29.81,a reduction of 31.26 episodes per duty (P < 0.001,95% CI 22.9-39.63).The time for the medication-related tasks was reduced from 32 min (SD =21.57) to 26.57 min (SD =11.35) and the medication administration time increased from 37.93 min (SD-14.78) to 44.37 min (SD 19.45),but there was no overall significant difference in the time spent on each duty (P =0.315) between the two groups.An improving trend in the delayed effect was observed (P =0.03),which indicated a run-in period for new application was needed in clinical setting.Conclusion:Our study had shown the time motion observation could be applied to measure the impact of the IPMOE in a busy clinical setting.Through classification of activities,validation,objective measurement and longitudinal evaluation,the method could be applied in various systems as well as different clinical settings in measure efficiency.展开更多
文摘Introduction:The In-patient Medication Order Entry System (IPMOE) was first implemented in the medical ward of Princess Margaret Hospital,Hong Kong.It was a local developed close-loop system including prescription,dispensing and administration modules.Evaluation on its impact on nursing tasks would be important for practice improvement and subsequent system enhancement.Objective:The study was conducted to quantify the nursing times across medication-associated tasks for paper-based MAR and computer-based IPMOE,including change in the tasks and time patterns before and after IPMOE implementation.Methods:This was a prospective observation study in medical wards before (Jan 2014-Jun 2014) and after (Mar 2015-Jun 2015) the implementation of IPMOE.We conducted 8-hr observation studies of individual nurses with a customized application to time various pre-categorized nursing tasks.Statistical inferences and interrupted time series analysis was performed to identify the change in the intercept and trends over time after implementation.Result:The average number of medication-related tasks was significantly reduced from 61.07 to 29.81,a reduction of 31.26 episodes per duty (P < 0.001,95% CI 22.9-39.63).The time for the medication-related tasks was reduced from 32 min (SD =21.57) to 26.57 min (SD =11.35) and the medication administration time increased from 37.93 min (SD-14.78) to 44.37 min (SD 19.45),but there was no overall significant difference in the time spent on each duty (P =0.315) between the two groups.An improving trend in the delayed effect was observed (P =0.03),which indicated a run-in period for new application was needed in clinical setting.Conclusion:Our study had shown the time motion observation could be applied to measure the impact of the IPMOE in a busy clinical setting.Through classification of activities,validation,objective measurement and longitudinal evaluation,the method could be applied in various systems as well as different clinical settings in measure efficiency.
