Nurses at Pittsburgh-based UPMC spend about a third of their shift interacting with technology and roughly 16 percent of their time on patient interaction and care, according to a study published in the Journal of Nursing Care Quality that sprung from nurses' concern that technology was taking up too much of their day.
In addition to nurses' feelings regarding technology, "it was also unclear how patients felt about the time they spent with their nurses," said Linda Higgins, PhD, RN, the study's lead author, "so we designed this project to gather multi-faceted data that could provide a comprehensive picture of nursing activity and guide future improvements in workflow and patient satisfaction."
Eleven trained observers shadowed 79 nurses on four inpatient units for one shift each, logging nurses' activities into predetermined categories. Nurses filled out a questionnaire about their shift, and the observers interviewed patients as well.
Patients reported spending 74 minutes on average with their nurse, with the vast majority (90 percent) saying that time was "excellent" or "good." However, the observers estimated nurses really only spent 40 minutes on average with each patient.
The activities the observers logged most frequently were:
- Documenting in the EHR — 11.5 percent
- Reviewing the EHR — 9.1 percent
- Patient assessment and interaction: 8.9 percent
- In-person communication with healthcare workers about patients — 7.5 percent
- Patient care and bedside procedures — 7.2 percent
About one-third of nurses' time was spent interaction with technology, according to the study.
"The project uncovered a discord between nurses' self-reported and direct observation of how time is actually spent during a shift," said Tami Minnier, MSN, UPMC's CQO, as nurses overestimated both the time they spent on the EHR and directly caring for patients, compared to the observers' findings.
"With these findings in mind, we can better target changes that may improve the way our nurses work, while also boosting patient satisfaction and outcomes," Ms. Minnier said.