Electronic Records With Tablets at the Point of Care in an Internal Medicine Unit: Before-After Time Motion Study

BackgroundThere are many benefits of nursing professionals being able to consult electronic health records (EHRs) at the point of care. It promotes quality and patient security, communication, continuity of care, and time dedicated to records. ObjectiveThe aim of...

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Main Authors: Montserrat Pérez-Martí, Lina Casadó-Marín, Abraham Guillén-Villar
Format: Article
Language:English
Published: JMIR Publications 2022-02-01
Series:JMIR Human Factors
Online Access:https://humanfactors.jmir.org/2022/1/e30512
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author Montserrat Pérez-Martí
Lina Casadó-Marín
Abraham Guillén-Villar
author_facet Montserrat Pérez-Martí
Lina Casadó-Marín
Abraham Guillén-Villar
author_sort Montserrat Pérez-Martí
collection DOAJ
description BackgroundThere are many benefits of nursing professionals being able to consult electronic health records (EHRs) at the point of care. It promotes quality and patient security, communication, continuity of care, and time dedicated to records. ObjectiveThe aim of this study was to evaluate whether making EHRs available at the point of care with tablets reduces nurses’ time spent on records compared with the current system. The analysis included sociodemographic and qualitative variables, time spent per patient, and work shift. This time difference can be used for direct patient care. MethodsA before-after time motion study was carried out in the internal medicine unit. There was a total of 130 observations of 2 hours to 3 hours in duration of complete patient records that were carried out at the beginning of the nurses' work shifts. We calculated the time dedicated to measuring vital signs, patient evaluation, and EHR recording. The main variable was time spent per patient. ResultsThe average time spent per patient (total time/patients admitted) was lower with the tablet group (mean 4.22, SD 0.14 minutes) than with the control group (mean 4.66, SD 0.12 minutes); there were statistically significant differences (W=3.20, P=.001) and a low effect (d=.44) between groups. The tablet group saved an average of 0.44 (SD 0.13) minutes per patient. Similar results were obtained for the afternoon shift, which saved an average of 0.60 (SD 0.15) minutes per patient (t34=3.82, P=.01) and high effect (d=.77). However, although there was a mean difference of 0.26 (SD 0.22) minutes per patient for the night shift, this was not statistically significant (t29=1.16, P=.25). The “nonparticipating” average age was higher (49.57, SD 2.92 years) compared with the “afternoon shift participants” and “night shift participants” (P=.007). “Nonparticipants” of the night shift had a worse perception of the project. ConclusionsThis investigation determined that, with EHRs at the point of care, the time spent for registration by the nursing staff decreases, because of reduced movements and avoiding data transcription. It eliminates unnecessary work that does not add value, and therefore, care is improved. So, we think EHRs at the point of care should be the future or natural method for nursing to undertake. However, variables that could have a negative effect include age, night shift, and nurses’ perceptions. Therefore, it is proposed that training in the different work platforms and the participation of nurses are fundamental axes that any institution should consider before their implementation.
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spelling doaj.art-a9142662c0b141bda72781fb21104a332023-08-28T20:46:06ZengJMIR PublicationsJMIR Human Factors2292-94952022-02-0191e3051210.2196/30512Electronic Records With Tablets at the Point of Care in an Internal Medicine Unit: Before-After Time Motion StudyMontserrat Pérez-Martíhttps://orcid.org/0000-0002-3048-0303Lina Casadó-Marínhttps://orcid.org/0000-0002-8078-1673Abraham Guillén-Villarhttps://orcid.org/0000-0002-3588-9327 BackgroundThere are many benefits of nursing professionals being able to consult electronic health records (EHRs) at the point of care. It promotes quality and patient security, communication, continuity of care, and time dedicated to records. ObjectiveThe aim of this study was to evaluate whether making EHRs available at the point of care with tablets reduces nurses’ time spent on records compared with the current system. The analysis included sociodemographic and qualitative variables, time spent per patient, and work shift. This time difference can be used for direct patient care. MethodsA before-after time motion study was carried out in the internal medicine unit. There was a total of 130 observations of 2 hours to 3 hours in duration of complete patient records that were carried out at the beginning of the nurses' work shifts. We calculated the time dedicated to measuring vital signs, patient evaluation, and EHR recording. The main variable was time spent per patient. ResultsThe average time spent per patient (total time/patients admitted) was lower with the tablet group (mean 4.22, SD 0.14 minutes) than with the control group (mean 4.66, SD 0.12 minutes); there were statistically significant differences (W=3.20, P=.001) and a low effect (d=.44) between groups. The tablet group saved an average of 0.44 (SD 0.13) minutes per patient. Similar results were obtained for the afternoon shift, which saved an average of 0.60 (SD 0.15) minutes per patient (t34=3.82, P=.01) and high effect (d=.77). However, although there was a mean difference of 0.26 (SD 0.22) minutes per patient for the night shift, this was not statistically significant (t29=1.16, P=.25). The “nonparticipating” average age was higher (49.57, SD 2.92 years) compared with the “afternoon shift participants” and “night shift participants” (P=.007). “Nonparticipants” of the night shift had a worse perception of the project. ConclusionsThis investigation determined that, with EHRs at the point of care, the time spent for registration by the nursing staff decreases, because of reduced movements and avoiding data transcription. It eliminates unnecessary work that does not add value, and therefore, care is improved. So, we think EHRs at the point of care should be the future or natural method for nursing to undertake. However, variables that could have a negative effect include age, night shift, and nurses’ perceptions. Therefore, it is proposed that training in the different work platforms and the participation of nurses are fundamental axes that any institution should consider before their implementation.https://humanfactors.jmir.org/2022/1/e30512
spellingShingle Montserrat Pérez-Martí
Lina Casadó-Marín
Abraham Guillén-Villar
Electronic Records With Tablets at the Point of Care in an Internal Medicine Unit: Before-After Time Motion Study
JMIR Human Factors
title Electronic Records With Tablets at the Point of Care in an Internal Medicine Unit: Before-After Time Motion Study
title_full Electronic Records With Tablets at the Point of Care in an Internal Medicine Unit: Before-After Time Motion Study
title_fullStr Electronic Records With Tablets at the Point of Care in an Internal Medicine Unit: Before-After Time Motion Study
title_full_unstemmed Electronic Records With Tablets at the Point of Care in an Internal Medicine Unit: Before-After Time Motion Study
title_short Electronic Records With Tablets at the Point of Care in an Internal Medicine Unit: Before-After Time Motion Study
title_sort electronic records with tablets at the point of care in an internal medicine unit before after time motion study
url https://humanfactors.jmir.org/2022/1/e30512
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AT abrahamguillenvillar electronicrecordswithtabletsatthepointofcareinaninternalmedicineunitbeforeaftertimemotionstudy