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Case Study Finds Computerized ICU Information System Can Significantly Reduce Time Spent by Nurses on Documentation

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Press Release Date: October 10, 2003

Installing a modern computerized medical information management system in hospital intensive care units can significantly reduce the time spent by ICU nurses on documentation, giving them more time for direct patient care, says a case study partially funded by the Agency for Healthcare Research and Quality. 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 one 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.

"This adds to the growing body of evidence that information technology can greatly improve the efficiency, effectiveness, and quality of health care delivery," said AHRQ Director Carolyn M. Clancy, M.D. "We are committed to supporting and encouraging the adoption of information technology by health care providers and institutions."

"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," said the study's lead author, Dr. David Wong of the Veterans' Affairs Long Beach Healthcare System. "Electronic information management systems would then allow ICU nurses to spend a greater proportion of their time providing direct patient care."

The study, "Changes in ICU nurse activity after installation of a third generation ICU information system," is published in the October issue of Critical Care Medicine.

For more information, please contact AHRQ Public Affairs: Karen Migdail, (301) 427-1855 (


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