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Installing a modern computerized medical information management system in hospital intensive care units (ICUs) can significantly reduce the time spent by ICU nurses on documentation and give them more time for direct patient care, according to a study that was funded in part by the Agency for Healthcare Research and Quality (HS11375 and HS11521). These systems use Windows NT as the operating system for bedside workstations and servers, use a relational database to store and manipulate data, and have improved graphics and user interfaces.
A research nurse observed ICU care and recorded moment-to-moment all of the tasks performed by ICU nurses before and after installation of the information system in a 10-bed surgical ICU at a Veterans Affairs medical center. The results showed a decrease in the time spent on documentation from 35.1 percent of the nurses' time to 24.2 percent of their time. This equates to saving 52 minutes in an 8-hour shift or more than 1 hour in a 12-hour shift. In addition, the number of times a nurse interrupted other tasks to document care decreased from eight times to less than three times per hour, thus enabling them to complete more tasks without interruption.
At the same time, the researchers documented an increase in time spent on direct patient care from 31 percent of nurses' time to 40 percent of their time. Time spent on patient assessment, considered a critical part of direct patient care, more than doubled to 9 percent of their total time.
Electronic information management systems similar to the one studied could be expected to reduce the amount of nurses' time spent on documentation tasks in similar ICU settings, after appropriate training, according to the study's lead author, David H. Wong, Pharm.D., M.D., of the Veterans' Affairs Long Beach Healthcare System.
For more information, see "Changes in ICU nurse activity after installation of a third generation ICU information system," by Dr. Wong, Yvonne Gallegos, R.N., M.S.N., Matthew B. Weinger, M.D., and others, in the October 2003 issue of Critical Care Medicine 31(10), pp. 2488-2494.
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