Background

An Electronic Health Record (EHR) has been introduced to four Irish maternity units, with further implementations planned. Previous studies indicate that healthcare professionals are concerned that EHRs may increase time spent on documentation and medication-related tasks.

Objective

To determine the impact of an EHR on task time distribution in a Neonatal Intensive Care Unit (NICU).

Methods

A pre-post, time and motion study. An electronic data collection tool was used to collate time spent on direct care, professional communication, reviewing charts, documentation, and medication-related tasks. Interruptions and contact with the patient zone were quantified. Statistical significance was assessed using two-sample proportion tests, two-sample t-tests, and two-sample Wilcoxon rank-sum tests. A Bonferroni correction set significance at p ≤ 0.0025.

Results

63 doctors and nurses participated, with 169.23 h of data collected. There were no significant changes to nurses’ task time distribution. The proportion of time spent by doctors on professional communication increased from 15.4% to 26.0% (p < 0.001). Significant increases to median task times were seen for both doctors and nurses. Interruptions to tasks decreased post-implementation (p < 0.001), as did frequency of contact with the patient zone (p < 0.001).

Conclusion

The EHR did not redistribute time towards documentation and medication-related tasks. A reduction in interruptions to tasks may streamline workflow. Decreased contact with the patient zone may improve patient safety through reduced potential for pathogen transmission.

中文翻译：

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电子病历对新生儿重症监护病房任务时间分配的影响

背景

电子健康记录（EHR）已引入爱尔兰的四个产妇部门，并计划进一步实施。先前的研究表明，医疗保健专业人员担心EHR可能会增加在文档和药物相关任务上花费的时间。

目的

若要确定EHR对新生儿重症监护病房（NICU）中任务时间分配的影响。

方法

事前，时间和动作研究。使用电子数据收集工具来整理在直接护理，专业沟通，检查图表，文档和药物相关任务上花费的时间。量化中断和与患者区域的接触。使用两样本比例检验，两样本t检验和两样本Wilcoxon秩和检验评估统计学显着性。Bonferroni校正将显着性设置为p≤0.0025。

结果

共有63位医生和护士参加，收集了169.23小时的数据。护士的工作时间分配没有明显变化。医生花在专业沟通上的时间比例从15.4％增加到26.0％（p <0.001）。医生和护士的中位工作时间均显着增加。中断任务减少了执行后的发生率（p <0.001），与患者区域的接触频率也有所降低（p <0.001）。

结论

EHR并未将时间重新分配给文档和与药物相关的任务。减少任务中断可以简化工作流程。与患者区域的接触减少可通过减少病原体传播的可能性来提高患者安全性。