se Study

Question se StudyAdapted from a study by Tschannen, Talsma, Reinemeyer, Belt, and Schoville (2011). A new computerized provider order entry system (CPOE) was installed in a rural hospital. Within a few months, nurse managers reported prolonged medication administration times in two units of the hospital. A team was formed to address any connections between the new system and the workflow issue. They decided to gather data on the process of medication administration from order entry to patient consumption of the medication by conducting an observational study on the units. One unit was a 20-bed adult medical ICU (MICU) and the other a 37-bed general pediatric unit. Nurse -to-patient ratios in the ICU were typically 1:1 or 2:1 and 1:3 or 1:4 on the peds unit. The team used a time-motion study with direct observations of nurses during their shift as they went through the process of administering medications to patients. They observed 50 pediatric and 36 MICU administrations of medications to patients over a period of 30 days.  Then nurses were interviewed to determine any issues they had with medication administration since the CPOE was implemented. There were four main areas of concern expressed by the nurses: system issues, variations in standards of care, variability of workflow, and changes in communication practices. The following are the specific issues reported in those areas:The process of medication administration had 17 distinct stepsRelocation of the med room resulted in increased interruptionsThe e-MAR screen print was too small, it required too much scrolling/clicking, and the medication reconciliation form was difficult to completeProviders were entering duplicate medication ordersNurses were unable to access the CPOE from patient rooms to check ordersComputers were slow and at times would not function properlyPediatric nurses took more time prepping meds because they were crushing/diluting someBecause there was no standardized time to check for new orders, nurses were inconsistent on checking for orders and care varied among patientsMed room was inadequate for using the new system due to crowding and lightingThere were no alerts on the CPOE for new or stat orders and no hard stop for duplicate ordersNurses and providers failed to communicate with each other about ordersHas to be entered into fishbone cause & effect diagram Health Science Science Nursing Share QuestionEmailCopy link Comments (0)