Wong, DC, Bonnici, T, Knight, J et al. (3 more authors) (2017) A ward-based time study of paper and electronic documentation for recording vital sign observations. Journal of the American Medical Informatics Association. ISSN 1067-5027
Abstract
Objective: To investigate time differences in recording observations and an Early Warning Score (EWS) using a traditional paper chart and a novel e-Obs system, in clinical practice. Methods: Researchers observed the process of recording observations and EWS across three wards in two university teaching hospitals immediately before and after the introduction of the e-Obs system. The process of recording observations included both measurement and documentation of vital signs. Interruptions were timed and subtracted from the measured process duration. Multilevel modelling was used to compensate for potential confounding factors. Results: 577 nurse events were observed (281 Paper, 296 e-Obs). The geometric mean time to take a complete set of vital signs was 215s (95% CI: 177s-262s) on paper, and 150s (95% CI: 130s-172s) electronically. The treatment effect ratio was 0.70 (95% CI: 0.57-0.85, p<0.001). The treatment effect ratio in ward 1 was 0.37 (95% CI: 0.26-0.53), in ward 2 was 0.98 (95% CI: 0.70-1.38), and in ward 3 was 0.93 (95% CI: 0.66-1.33). The treatment effect ratios on wards 2 (p=0.91) and 3 (p=0.70) were not significant. Discussion: Introduction of an e-Obs system was associated with a statistically significant reduction in overall time to measure and document vital signs electronically, in comparison to paper documentation. The reductions in time varied between wards and were of clinical significance on only one of three wards studied. Conclusion: Our results suggest that the introduction of an e-Obs system may lower nursing workload in addition to increasing documentation quality.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. This is a pre-copyedited, author-produced PDF of an article accepted for publication in Journal of the American Medical Informatics Association following peer review. The version of record, Wong, DC, Bonnici, T, Knight, J et al. (3 more authors) (2017) A ward-based time study of paper and electronic documentation for recording vital sign observations. Journal of the American Medical Informatics Association. ISSN 1067-5027, is available online at: https://doi.org/10.1093/jamia/ocw186 |
Keywords: | vital signs; electronic charting; early warning score; time and motion studies |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Yorkshire Centre for Health Informatics (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 03 Jan 2017 11:37 |
Last Modified: | 11 Feb 2018 01:38 |
Published Version: | https://doi.org/10.1093/jamia/ocw186 |
Status: | Published |
Publisher: | Oxford University Press |
Identification Number: | 10.1093/jamia/ocw186 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:109945 |