Utilizing a Human Factors Nursing Worksystem Improvement Framework to Increase Nurses’ Time at the Bedside and Enhance Safety

Abstract

An innovative human factors framework for nursing worksystem improvement provided practical and high priority targets for interventions that significantly improved the nursing worksystem.

Methods used to examine technology in relation to the quality of nursing work in acute care: A systematic integrative review

“…A majority used time and motion methods ( n = 26) where a range of classifications of nurse activities were used; in 27% ( n = 13) of these studies, multiple dimensions of nursing work were examined. Organisational aspects of nursing work were examined in 31.7% ( n = 13) of studies and included costings, access to resources and satisfaction. Ten of these studies examined multiple dimensions of nursing work. Cognitive nursing work was examined in only 17.1% ( n = 8) of studies; these examined cognitive workload (Colligan, Potts, Finn, & Sinkin, ), interruptions (Probst et al, ; Reed, Minnick, & Dietrich, ), multi‐tasking (Reed et al, ), work sequence (Cornell, Riordan, Townsend‐Gervis, & Mobley, ), errors (Cordero, Kuehn, Kumar, & Mekhjian, ; Westbrook, Li, Georgiou, Paoloni, & Cullen, ) and information sources for decision‐making (Asaro & Boxerman, ; Westbrook et al, ; Zadvinskis, Chipps, & Yen, ; Zuzelo, Gettis, Hansell, & Thomas, ) in nursing work. Emotional nursing work was examined in only 12.2% ( n = 5) of studies; all these studies also captured other dimensions of nursing work. Emotional aspects of nursing work included nurses' feelings about the technology and their work (Bennett, Harper‐Femson, Tone, & Rajmohamed, ; Gomes, Hash, Orsolini, Watkins, & Mazzoccoli, ; Kossman & Scheidenhelm, ; Zuzelo et al, ), and providing emotional support to patients (Gomes et al, ) and their families (Schenk et al, ).…”

“…Seven of the eight (80%) examined the physical domain of nursing work. Of these, Fahey, Lopez, Storfjell, and Keenan () examined only physical work while the other six examined additional dimensions: five examined organisational aspects (Bennett et al, ; Dearmon et al, ; Gomes et al, ; Hsieh et al, ; Kossman & Scheidenhelm, ), three examined emotional aspects (Bennett et al, ; Kossman & Scheidenhelm, ; Schenk et al, ), and one examined cognitive aspects (Probst et al, ) of nursing work. Alternatively, Dearmon et al () examined only organisational work.…”

“…Seven of the eight (80%) examined the physical domain of nursing work using a range of direct observation methods to collect quantitative data, in combination with another method for data collection. Structured continuous (Bennett et al, ) or intermittent (Dearmon et al, ) observations (Gomes et al, ; Probst et al, ; Schenk et al, ) were most common, while Kossman and Scheidenhelm () used unstructured field observations. Fahey et al () captured nurses' movements electronically using RFID tracking, and Probst et al () used electronic location data for a similar purpose.…”

“…Structured continuous (Bennett et al, ) or intermittent (Dearmon et al, ) observations (Gomes et al, ; Probst et al, ; Schenk et al, ) were most common, while Kossman and Scheidenhelm () used unstructured field observations. Fahey et al () captured nurses' movements electronically using RFID tracking, and Probst et al () used electronic location data for a similar purpose. Alternatively, Hsieh et al () combined surveys and medical record audit to examine both physical and organisational domains of nursing work.…”

“…Other methods used in combination with direct observation included focus groups (Bennett et al, ) or individual interviews (Kossman & Scheidenhelm, ; Probst et al, ), quantitative (Dearmon et al, ; Gomes et al, ; Schenk et al, ) and qualitative (Fahey et al, ; Kossman & Scheidenhelm, ) surveys, and organisational data such as safety or incident reports (Dearmon et al, ) or call bell (Fahey et al, ).…”