Multitasking during Medication Management in a Nursing Home: A Time Motion Study.

Area of Science:

• Nursing Science
• Healthcare Management
• Clinical Informatics

Background:

• Multitasking in clinical settings increases cognitive burden and risk of errors.
• Time motion study (TMS) data indicate extensive multitasking by nurses during medication management in nursing homes.
• Understanding multitasked nursing interventions is crucial for optimizing medication management workflows.

Purpose of the Study:

• To describe pairs of multitasked nursing interventions associated with medication management using a continuous observational TMS method.
• To investigate interventions including medication preparation, administration, effect assessment, instruction, and documentation.
• To provide a foundation for optimizing medication management workflows.

Main Methods:

• Utilized a continuous observational Time Motion Study (TMS) method.
• Employed 57 predefined Omaha System nursing interventions within TimeCaT software for data collection.
• Analyzed 120 hours of time-stamped observation data from nine nurses in a single nursing home.

Main Results:

• The majority (74%) of medication management interventions involved multitasking, resulting in 2,003 intervention pairs.
• Thirty-five of 57 Omaha System interventions were part of multitasking pairs.
• Multitasked medication preparation took longer (162s vs. 81s), while documentation was shorter (66s vs. 93s).

Conclusions:

• Medication management in nursing homes is complex, characterized by numerous and diverse multitasking pairs.
• Findings offer a basis for studying medication management multitasking and developing clinical/informatics solutions.
• The TMS method can be applied to examine multitasking in other clinical settings.