Time spent on daytime direct care activities by personal carers in two Australian residential aged care facilities: a time–motion study

Qian, Siyu; Yu, Ping; Hailey, David; Zhang, Zhenyu; Davy, Pamela J.; Nelson, Mark

doi:10.1071/ah13161

Cited by 23 publications

(20 citation statements)

References 16 publications

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“…Time-motion observation has been used by previous studies to evaluate the care processes in RACHs [11,12]. It requires an observer to follow one participant at a time and sequentially record the time taken for the person to conduct an activity, using a pre-defined activity classification system.…”

Section: Data Collection Methodsmentioning

confidence: 99%

The impact of electronic medication administration records in a residential aged care home

Qian¹,

Yu²,

Hailey³

2015

International Journal of Medical Informatics

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This study aimed to compare between electronic medication administration records and paper-based records in the nursing time spent on various activities in a medication round and the medicationadministration processes followed by nurses in an Australian residential aged care home. It also aimedto identify the benefits and unintended adverse consequences of using the electronic medication admin-istration records.Methods: Time-motion observation, taking of field notes, informal conversation and document reviewwere used to collect data in two units of a residential aged care home. Each unit had one nurse admin-ister medication. Seven nurses were observed over 12 morning shifts. Unit 1 used electronic medicationadministration records and Unit 2 used paper-based records.Results: No significant difference between the two units was found in the nursing time spent on variousactivities in a medication round, including documentation, verbal communication, medication adminis-tration, infection control and transit.Comparison of the medication administration processes between the electronic and paper-basedmedication administration records identified a procedural problem which violated the organization'sdocumentation requirement. This problem was documenting before providing medication to a residentwhen using the paper-based records. It was not observed with the electronic medication administrationrecords.Benefits of introducing the electronic medication administration records included improving nurses'compliance with documentation requirements, freedom from the error of signing twice, reducing thepossibility of forgetting to medicate a resident, facilitating nurses to record the time of medicationadministration to a resident and increasing documentation space. Unintended adverse consequencesof introducing the electronic medication administration records included inadequate information aboutresidents, late addition of a new resident's medication profile in the records and nurses' forgetting tomedicate a resident due to power outage of the portable device.Conclusions: The electronic medication administration records may not change nursing time spent onvarious activities in a medication round or substantially alter the medication administration processes,but can generate both benefits and unintended adverse consequences. Future research may investigatewhether and how the adverse consequences can be prevented.

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Section: Data Collection Methodsmentioning

confidence: 99%

The impact of electronic medication administration records in a residential aged care home

Qian¹,

Yu²,

Hailey³

2015

International Journal of Medical Informatics

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“…Residents are supported in activities of daily living by care staff (Kusmaul & Bunting, ), also known as certified nursing assistants, auxiliary nurses or personal care assistants; hence, care staff are suitably positioned to play an important role in assisting residents to prevent falls. Previous studies have estimated that care staff in RAC settings spend from 45.4% to 80% of their 8‐hr working shift in direct resident contact delivering care (Gray et al, ; Qian et al, ). In contrast, allied health professionals, such as physiotherapists, only provide on average 55 min of direct resident care per week in these settings (Qian et al, ).…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have estimated that care staff in RAC settings spend from 45.4% to 80% of their 8‐hr working shift in direct resident contact delivering care (Gray et al, ; Qian et al, ). In contrast, allied health professionals, such as physiotherapists, only provide on average 55 min of direct resident care per week in these settings (Qian et al, ). This suggests that care staff have more opportunity, through resident contact time, to influence residents to prevent falls on a daily basis, provided they have the necessary knowledge and skills.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of care staff knowledge, confidence, motivation and opportunity for preventing falls in residential aged care settings: A cross‐sectional survey

Francis‐Coad

Hang

Etherton‐Beer

et al. 2019

Int J Older People Nursing

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Aims:To explore care staff knowledge about falls and confidence, motivation and opportunity to undertake fall prevention strategies, in residential aged care (RAC) along with preferences for fall prevention education.Background: Falls account for the majority of adverse clinical events in RAC settings.Care staff in RAC settings are in a key position to influence residents' actions to prevent falls, provided they have the necessary knowledge and skills. Methods:A cross-sectional survey design with a purposive sample of 147 care staff at eight RAC facilities was undertaken in 2015. A custom-designed questionnaire examining knowledge, confidence, motivation and opportunity to undertake falls prevention strategies was used. Results:Only 39 (26.5%) care staff were aware that the residents they cared for were at high risk of falls. Care staff knowledge of intrinsic falls risk factors was very limited, for example, only 18 (13.53%) observed for side effects of medication and just four (1.04%) were aware of continence issues. Conflicting duties also limited care staff time to undertake falls prevention strategies. Preferences for falls prevention education indicated face-to-face interactive discussions in the workplace (n = 98, [66.7%]) with reminder posters displayed around the facility (n = 80, [70.8%]). Conclusions:Residential aged care organisations need to engage with care staff to provide tailored falls education incorporating learning preferences and targeting knowledge gaps, to improve awareness of intrinsic risk factor impact and uptake of evidence-based prevention strategies. Despite care staff being highly motivated, they have limited opportunity to assist residents with fall prevention within their workload. RAC management and funding bodies must address opportunity for care staff to fulfil this crucial role to benefit resident safety. Implication for practice:This study identified gaps in care staffs' knowledge and skills in undertaking falls prevention strategies in residential aged care settings.These findings will assist residential aged care organisations and health professional educators to design evidence-based falls prevention education tailored to their care staffs' needs and preferences to facilitate adoption.

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“…Studies investigating personal care activities in RAC homes have examined the time spent by nursing staff on these activities, [3][4][5][6][7][8][9][10] with some describing the work processes of personal carers in conducting specific activities (e.g. bathing, oral care).…”

Section: Introductionmentioning

confidence: 99%

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

Qian¹,

Yu²,

Hailey³

2016

Aust. Health Review

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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.

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Time spent on daytime direct care activities by personal carers in two Australian residential aged care facilities: a time–motion study

Cited by 23 publications

References 16 publications

The impact of electronic medication administration records in a residential aged care home

The impact of electronic medication administration records in a residential aged care home

Evaluation of care staff knowledge, confidence, motivation and opportunity for preventing falls in residential aged care settings: A cross‐sectional survey

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

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