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    Nursing time devoted to medication administration in long-term care: clinical, safety, and resource implications.

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    Authors
    Thomson, Mary S.
    Gruneir, Andrea
    Lee, Monica
    Baril, Joann L.
    Field, Terry S.
    Gurwitz, Jerry H.
    Rochon, Paula A.
    UMass Chan Affiliations
    Department of Medicine, Division of Geriatric Medicine
    Meyers Primary Care Institute
    Document Type
    Journal Article
    Publication Date
    2009-02-01
    Keywords
    Drug Therapy
    Efficiency
    Hospital Units
    Humans
    Long-Term Care
    Safety
    Time
    Health Services Research
    Medicine and Health Sciences
    
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    Link to Full Text
    http://dx.doi.org/10.1111/j.1532-5415.2008.02101.x
    Abstract
    OBJECTIVES: To quantify the time required for nurses to complete the medication administration process in long-term care (LTC). DESIGN: Time-motion methods were used to time all steps in the medication administration process. SETTING: LTC units that differed according to case mix (physical support, behavioral care, dementia care, and continuing care) in a single facility in Ontario, Canada. PARTICIPANTS: Regular and temporary nurses who agreed to be observed. MEASUREMENTS: Seven predefined steps, interruptions, and total time required for the medication administration process were timed using a personal digital assistant. RESULTS: One hundred forty-one medication rounds were observed. Total time estimates were standardized to 20 beds to facilitate comparisons. For a single medication administration process, the average total time was 62.0+/-4.9 minutes per 20 residents on physical support units, 84.0+/-4.5 minutes per 20 residents on behavioral care units, and 70.0+/-4.9 minutes per 20 residents on dementia care units. Regular nurses took an average of 68.0+/-4.9 minutes per 20 residents to complete the medication administration process, and temporary nurses took an average of 90.0+/-5.4 minutes per 20 residents. On continuing care units, which are organized differently because of the greater severity of residents' needs, the medication administration process took 9.6+/-3.2 minutes per resident. Interruptions occurred in 79% of observations and accounted for 11.5% of the medication administration process. CONCLUSION: Time requirements for the medication administration process are substantial in LTC and are compounded when nurses are unfamiliar with residents. Interruptions are a major problem, potentially affecting the efficiency, quality, and safety of this process.
    Source
    J Am Geriatr Soc. 2009 Feb;57(2):266-72. Epub 2008 Dec 11.
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/37285
    PubMed ID
    19170782; 19170782
    Related Resources
    Link to article in PubMed
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    UMass Chan Faculty and Researcher Publications

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