scholarly journals Nursing staff work patterns in a residential aged care home: a time–motion study

2016 ◽  
Vol 40 (5) ◽  
pp. 544 ◽  
Author(s):  
Siyu Qian ◽  
Ping Yu ◽  
David Hailey

Objective Residential aged care services are challenged by an increasing number of residents and a shortage of nursing staff. Developing strategies to overcome this challenge requires an understanding of nursing staff work patterns. The aim of the present study was to investigate the work processes followed by nursing staff and how nursing time is allocated in a residential aged care home. Methods An observational time–motion study was conducted at two aged care units for 12 morning shifts. Seven nurses were observed, one per shift. Results In all, there were 91 h of observation. The results showed that there was a common work process followed by all nurse participants. Medication administration, documentation and verbal communication were the most time-consuming activities and were conducted most frequently. No significant difference between the two units was found in any category of activities. The average duration of most activities was less than 1 min. There was no difference in time utilisation between the endorsed enrolled nurses and the personal carers in providing nursing care. Conclusion Medication administration, documentation and verbal communication were the major tasks in morning shifts in a residential aged care home. Future research can investigate how verbal communication supports nursing care. What is known about the topic? The aging population will substantially increase the demand for residential aged care services. There is a lack of research on nurses’ work patterns in residential aged care homes. What does this paper add? The present study provides a comprehensive understanding of nurses’ work patterns in a residential aged care home. There is a common work process followed by nurses in providing nursing care. Medication administration, verbal communication and documentation are the most time-consuming activities and they are frequently conducted in the same period of time. Wound care, physical review and documentation on desktop computers are arranged flexibly by the nurses. What are the implications for practitioners? When developing a task reallocation strategy to improve work efficiency, effort can be put into tasks that can be arranged more flexibly.

2018 ◽  
Vol 26 (8) ◽  
pp. 1033-1043 ◽  
Author(s):  
Siyu Qian ◽  
Ping Yu ◽  
David Hailey ◽  
Ning Wang ◽  
Anol Bhattacherjee

Author(s):  
Esa Y. H. Chen ◽  
J. Simon Bell ◽  
Jenni Ilomäki ◽  
Megan Corlis ◽  
Michelle E. Hogan ◽  
...  

2020 ◽  
Author(s):  
Stephanie M Garratt ◽  
Ngaire M Kerse ◽  
Kathryn Peri ◽  
Monique F Jonas

Abstract Background A medication omission is an event where a prescribed medication is not taken before the next scheduled dose. Medication omissions are typically classed as errors within Residential Aged Care (RAC) homes, as they have the potential to lead to harm if poorly managed, but may also stem from good clinical decision-making. This study aimed to quantify the incidence, prevalence, and types of medication omissions in RAC homes on a national scale, using a New Zealand-based sample. Methods We conducted retrospective pharmacoepidemiology of de-identified medication administration e-records from December 1st 2016 to December 31st 2017. Four tiers of de-identified data were collected: RAC home level data (ownership, levels of care), care staff level data (competency level/role), resident data (gender, age, level of care), and medication related data (omissions, categories of omissions, recorded reasons for omission). Data were analysed using SPSS version 24 and Microsoft Excel.Results A total of 11, 015 residents from 374 RAC homes had active medication charts; 8,020 resided in care over the entire sample timeframe. A mean rate of 3.59 medication doses were omitted per 100 (±7.43) dispensed doses/resident. Seventy-three percent of residents had at least one dose omission. The most common omission category used was ‘not-administered’ (49.9%), followed by ‘refused’ (34.6%). The relationship between ownership type and mean rate of omission was significant (p=0.002), corporate operated RAC homes had a slightly higher mean (3.73 versus 3.33), with greater variation. The most commonly omitted medications were Analgesics and Laxatives. Forty-eight percent of all dose omissions were recorded without a comment justifying the omission. Conclusions This unique study is the first to report rate of medication omissions per RAC resident over a one-year timeframe. Although the proportion of medications omitted reported in this study is less than previously reported by hospital-based studies, there is a significant relationship between a resident’s level of care, RAC home ownership types, and the rate of omission.


2014 ◽  
Vol 05 (04) ◽  
pp. 971-987 ◽  
Author(s):  
E. Lehnbom ◽  
K. Oliver ◽  
A. Georgiou ◽  
C. Rowe ◽  
T. Osmond ◽  
...  

SummaryIntroduction: Electronic medication administration record (eMAR) systems are promoted as a potential intervention to enhance medication safety in residential aged care facilities (RACFs). The purpose of this study was to conduct an in-practice evaluation of an eMAR being piloted in one Australian RACF before its roll out, and to provide recommendations for system improvements.Methods: A multidisciplinary team conducted direct observations of workflow (n=34 hours) in the RACF site and the community pharmacy. Semi-structured interviews (n=5) with RACF staff and the community pharmacist were conducted to investigate their views of the eMAR system. Data were analysed using a grounded theory approach to identify challenges associated with the design of the eMAR system.Results: The current eMAR system does not offer an end-to-end solution for medication management. Many steps, including prescribing by doctors and communication with the community pharmacist, are still performed manually using paper charts and fax machines. Five major challenges associated with the design of eMAR system were identified: limited interactivity; inadequate flexibility; problems related to information layout and semantics; the lack of relevant decision support; and system maintenance issues.We suggest recommendations to improve the design of the eMAR system and to optimize existing workflows.Discussion: Immediate value can be achieved by improving the system interactivity, reducing inconsistencies in data entry design and offering dedicated organisational support to minimise connectivity issues. Longer-term benefits can be achieved by adding decision support features and establishing system interoperability requirements with stakeholder groups (e.g. community pharmacies) prior to system roll out. In-practice evaluations of technologies like eMAR system have great value in identifying design weaknesses which inhibit optimal system use.Citation: Tariq A, Lehnbom E, Oliver K, Georgiou A, Rowe C, Osmond T, Westbrook J. Design challenges for electronic medication administration record systems in residential aged care facilities: a formative evaluation. Appl Clin Inf 2014; 5: 971–987http://dx.doi.org/10.4338/ACI-2014-08-RA-0062


2016 ◽  
Vol 17 (2) ◽  
pp. 148-154 ◽  
Author(s):  
Astrid Tuinman ◽  
Mathieu H.G. de Greef ◽  
Wim P. Krijnen ◽  
Roos M.B. Nieweg ◽  
Petrie F. Roodbol

2018 ◽  
Vol 74 (8) ◽  
pp. 1975-1983
Author(s):  
Julie M. Ellis ◽  
Beatriz Paulina Ayala Quintanilla ◽  
Louise Ward ◽  
Fergus Campbell ◽  
Stav Hillel ◽  
...  

2019 ◽  
Vol 4 (1) ◽  
pp. 256-286
Author(s):  
Ilona Pappne Demecs ◽  
Evonne Miller

For six months, a tapestry artist/researcher moved her studio into an aged care home to conduct a participatory art project. Drawing on ethnographic-based qualitative approaches, narrative inquiry and researcher-generated photographs, this arts-based research textually and visually documents the impact of introducing the studio-based craft activity of participatory tapestry weaving into an aged care environment. As well as highlighting the joy of creative collaboration and of learning a new skill, this project explores how tapestry weaving facilitated the understanding of the participants’ worlds through stories and reminiscence. This paper also disseminates that craft, as a practice and method, connects materials, ideas and people through engagement, and facilitates wellbeing. Given rapid population ageing, and the fear and stigma surrounding aged care homes, this paper argues that craft practice might help demystify and connect aged care with the broader community, as well as enhancing residents’ quality of life.


2021 ◽  
Vol 22 (1) ◽  
pp. 117-123.e1 ◽  
Author(s):  
Leonie Picton ◽  
Jenni Ilomäki ◽  
Claire S. Keen ◽  
Samanta Lalic ◽  
Beverly Adams ◽  
...  

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