The Problem of Sequential Entry of Nurses as a Disincentive to Medical Safety and a Factor Increasing Overtime

The purpose of this study was to visualize the nurses' approach to recording and to identify the causes that lead to overtime. The data used were those related to the performance and entry of nursing tasks (observation and care acts). Data from Hospital A, a provider of acute care with approximately 400 beds, was used. One month of work data were obtained from 12 nurses who were judged by the chief nurse to be excellent and efficient in their work. 12 nurses were divided into three groups: a high-level sequential entry rate group (>0.6), a medium-level sequential entry rate group (0.4 to <0.6), and a low-level sequential entry rate group (<0.4). The high-level sequential input rate group had data input every time they performed their work, so that the work implementation and input implementation were completed at 5:00 p.m. The medium-level sequential entry rate group tended to enter data about an hour late when they started work, which tended to result in overtime. The low-level sequential input rate group tended to input work in the afternoon, resulting in significant overtime. The data of approximately 400 nurses in a 900-bed University Hospital B, where Team Compass is implemented, were used to analyze the actual sequential input rate. 884 nurses in University Hospital B, of whom 397 had input data for 19 consecutive months. The sequential input rate in November 2020, one and a half years after the start of operation, was divided into five groups by 20%: 0-20%: 27 (7%), 20-40%: 30 (7%), 40-60%: 37 (9%), 60-80%: 69 (17%), and over 80%: 234 (59%). The number of employees who have been working overtime hours is also high. Although the importance of sequential entry to achieve results in reducing overtime hours continued to be strongly presented, there were 23% of nurses who indicated a sequential entry rate of less than 60%.