Changes in intensive care unit nurse task activity after installation of a third-generation intensive care unit information system

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Abstract
OBJECTIVE To determine the percentage of time that intensive care unit (ICU) nurses spend on documentation and other nursing activities before and after installation of a third-generation ICU information system. Prospective data collection using real-time time-motion analysis, before and after installation of the ICU information system. A ten-bed surgical ICU at a Veterans Affairs medical center. ICU nurses. Installation of a third-generation ICU information system. Ten ICU nurses were studied before and after installation of the ICU information system. Each ICU nurse's activities and tasks, during 4-hr observation periods, were categorized in real-time by a nurse observer and recorded in a laptop computer. Each recorded task was automatically time-stamped and logged into a data file. The percentage of time spent on documentation decreased from 35.1 +/- 8.3% to 24.2 +/- 7.6% (p =.025) after the ICU information system was installed. The percentage of time providing direct patient care increased from 31.3 +/- 9.2% to 40.1 +/- 11.7% (p =.085). The percentage of time doing patient assessment, a direct patient care task, increased from 4.0 +/- 4.7% to 9.4 +/- 4.4% (p =.001). Installation of a third-generation ICU information system decreased the percentage of time ICU nurses spent on documentation by >30%. Almost half of the time saved on documentation was spent on patient assessment, a direct patient care task.