ABSTRACT
Nurse leaders from a sample of acute care and long-term care sites participating in the Health Outcomes for Better Information and Care program in Ontario provided information on their experiences with HOBIC implementation. In addition, they described strategies to enhance successful implementation of the program. Finally, they discussed the potential future uses they envisioned for healthcare settings from the HOBIC data. Organizational benefits, such as data comparability, effective patient care planning and delivery and enhancement of nurses' technology skills were identified. Challenges that were highlighted included attaining buy-in from staff nurses, integration of HOBIC into existing computer systems and the subsequent computer and information technology challenges related to implementing such a program. Additional education and support for nursing staff and management were suggested as approaches for overcoming barriers. This survey demonstrates interest and commitment to HOBIC from many nurse leaders in Ontario and highlights the value that such a program provides for staff nurses in the planning and implementation of care. Nurse leaders in Ontario are keenly aware of the important potential that HOBIC data can provide for high-quality patient care and have identified key factors that need to be considered with the implementation of such a program.
Subject(s)
Attitude of Health Personnel , Medical Records Systems, Computerized , Nursing Records , Outcome and Process Assessment, Health Care , Health Care Surveys , Health Plan Implementation , Humans , Nurse Administrators , OntarioABSTRACT
AIM: To examine interruptions to nurses' work, the systems issues related to these and the associated outcomes. BACKGROUND: While some research has described the role interruptions play in medication errors, work is needed to examine specific factors in the nursing work environment that cause interruptions and to assess the impact of these on nurses' work and patient outcomes. METHODS: The present study utilized a mixed method design that involved work observation to detect nursing interruptions in the workplace followed by focus groups with a subsample of nurses. RESULTS: A total of 13,025 interruptions were observed. Equal numbers of these took place on medical and surgical units. The predominant source of interruptions was members of the health team, who interrupted more frequently on medical units. CONCLUSIONS: Differences in the type of patient and the care needs between medical and surgical units may be a contributing factor to these findings. As members of the health team were among the leading source of interruptions, an interdisciplinary team-based approach to changing the organization and design of work should be explored. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse leaders should examine ways in which nurses' work can benefit from system improvements to reduce interruptions that lead to patient safety issues such as treatment delays and loss of concentration.
Subject(s)
Nursing Staff, Hospital/organization & administration , Time Management/organization & administration , Efficiency, Organizational , Focus Groups , Health Services Research , Humans , Ontario , Quality of Health Care , Task Performance and Analysis , Workload/psychologyABSTRACT
This study explored interruptions in pediatric nurses' work and the systems issues related to interruptions in nursing work environments. A total of 5,325 interruptions were observed in this study, providing information on sources, types, and causes of interruptions. The nursing work being performed when interrupted and the outcomes of these interruptions are described.
