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17. Time Spent by Intensive Care Unit Nurses on the Electronic Health Record.

Author

Khan, Ahsan R., Rosenthal, Courtney D., Ternes, Kelly, Sing, Ronald F., and Sachdev, Gaurav

Subjects
AUDITING, SHIFT systems, PSYCHOLOGICAL burnout, INTENSIVE care nursing, SCIENTIFIC observation, TIME, JOB stress, RETROSPECTIVE studies, PATIENT satisfaction, DOCUMENTATION, JOB satisfaction, HOSPITAL nursing staff, ELECTRONIC health records
Abstract

Background: The amount of time spent on the electronic health record is often cited as a contributing factor to burnout and work-related stress in nurses. Increased electronic health record use also reduces the time nurses have for direct contact with patients and families. There has been minimal investigation into the amount of time intensive care unit nurses spend on the electronic health record. Objective: To quantify the amount of time spent by intensive care unit nurses on the electronic health record. Methods: In this observational study, active electronic health record use time was analyzed for 317 intensive care unit nurses in a single institution from January 2019 through July 2020. Monthly data on electronic health record use by nurses in the medical, neurosurgical, and surgical-trauma intensive care units were evaluated. Results: Full-time intensive care unit nurses spent 28.9 hours per month on the electronic health record, about 17.5% of their clinical shift, for a total of 346.3 hours per year. Part-time nurses and those working as needed spent 20.5 hours per month (17.6%) and 7.4 hours per month (14.2%) on the electronic health record, respectively. Neurosurgical and medical intensive care unit nurses spent 25.0 hours and 19.9 hours per month, respectively. Nurses averaged 23 clicks per minute during use. Most time was spent on the task of documentation at 12.3 hours per month, which was followed by medical record review at 2.6 hours per month. Conclusion: Intensive care unit nurses spend at least 17% of their shift on the electronic health record, primarily on documentation. Future interventions are necessary to reduce time spent on the electronic health record and to improve nurse and patient satisfaction. [ABSTRACT FROM AUTHOR]

Published
2022
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21. Venous thromboembolism in trauma: an update for the intensive care unit practitioner

Author

Rogers, Frederick, Rebuck, Jill A., and Sing, Ronald F.

Subjects
Thrombophlebitis -- Prevention -- Causes of -- Diagnosis, Pulmonary embolism -- Prevention -- Diagnosis -- Causes of, Intensive care units, Health, Practice, Diagnosis, Prevention, Causes of
Abstract

Venous thromboembolism (VTE) in trauma patients is a capricious problem that continues to plague trauma surgeons and critical care physicians alike. Pharmacologic preventions of VTE with anticoagulants are often contraindicated [...]

Published
2007

26. Emergency medicine residents spend over 7.5 months of their 3‐year residency on the electronic health record.

Author

Olson, Elizabeth, Rushnell, Chelsea, Khan, Ahsan, Cunningham, Kyle W., Allen, Bryant, Fox, Sean M., Sing, Ronald F., and Sachdev, Gaurav

Subjects
ELECTRONIC health records, PATIENT care
Abstract

Background: Use of the electronic health record (EHR) is a standard component of modern patient care. Although EHRs have improved since inception, cumbersome workflows decrease the time for residents to spend on clinical and educational activities. This study aims to quantify the time spent interacting with the EHR during a 3‐year emergency medicine (EM) residency. Methods: System records of time spent actively engaged in EHR use were analyzed for 98 unique EM residents over a period of 5 years from July 2015 to June 2020. Time spent on the EHR was totaled to give a career time, with a "work month" defined as a 4‐week period of 70.5 h per week, based on Accreditation Council for Graduate Medical Education work hour restrictions for EM residents. Engagement in specific activities such as chart review, documentation preparation, and order entry were separately analyzed. Results: Over their 3‐year training, a resident interacted with the EHR for 2,171 continuous hours. This amounts to 30.8 work weeks or 7.7 work months. Chart review was the most time‐intensive activity at 11.42 weeks. Documentation accounted for 9.91 weeks, with an average career total of 7,280 notes created. Additionally, each resident spent 4.57 weeks on order entry, with 46,347 orders entered during training. While the number of charts opened increased after first year of residency, average time spent on each activity per patient decreased. Conclusions: This unique study quantifies the total time an EM resident spends on the EHR during a 3‐year residency. Use of the EHR accounted for over 7.5 work months or nearly 21% of their training. Residents spend a substantial portion of their training interacting with the EHR and workflow improvements to reduce EHR time are critical for maximizing training time. [ABSTRACT FROM AUTHOR]

Published
2021
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44. Letters to the Editor

Author

Hoff, William S., McMahon, Damian J., Schwab, C. William, and Sing, Ronald F.

Published
1997

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