The impact of automated medicine dispensing units on nursing workflow: A cross-sectional study.
Automated dispensing cabinets
Automated dispensing machine
Automated dispensing unit
Drug administration
Hospital medication systems
Nurses/midwives/nursing staff
Patient safety
Pharmacy
workflow
Journal
International journal of nursing studies
ISSN: 1873-491X
Titre abrégé: Int J Nurs Stud
Pays: England
ID NLM: 0400675
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
17
04
2020
revised:
31
08
2020
accepted:
07
09
2020
pubmed:
2
10
2020
medline:
29
7
2021
entrez:
1
10
2020
Statut:
ppublish
Résumé
Automated medication dispensing cabinets are ubiquitous in hospitals in the United States and prevalent in Canada, but they are still relatively new to health services elsewhere. The automation of medication management using distributed dispensing units is aimed at improving stock management and patient safety; however, the evidence for the latter remains equivocal, and the impact on nursing workflow is poorly understood. This study evaluated the impact on the nursing workflow of a distributed automated medication dispensing system. The research aimed to explore the acceptability and utility of this system in a variety of clinical settings and to investigate similarities and differences in the use of the dispensing cabinets across different clinical areas. A cross-sectional design was employed. The setting was a newly constructed 450-bed regional Australian tertiary hospital. The study involved 174 registered nurses and 12 pharmacy assistant staff from general ward and specialty areas who were using the automated medication dispensing cabinets. Methods included a hospital-wide survey of users and an observation study of nursing workflow around the automated medication cabinets in specific clinical areas. The majority of staff were satisfied with the system and were positive about the overall safety and security. Key concerns related to access delays, and increased time needed due to walking distance and interruptions from other staff. Staff perceived that the automated medication dispensing cabinet use slowed medication administration processes as a result of queueing, and it also had other impacts on workflow. The system was found to expedite processes around controlled/narcotic drug administration. Re-stocking requirements presented operational issues; pharmacy assistants were observed waiting for opportunities to complete re-stocking tasks in the face of competing clinical requirements. Nurses from general wards were more satisfied with the system than those from specialty areas. Automated medication dispensing cabinets were widely accepted by nurses in a large newly opened hospital in a variety of acute clinical areas despite disruptions to workflow. Adaptations for access were more acceptable to nurses in general wards than those in specialty areas prompting consideration of redesign to improve suitability. Tweetable abstract: Automated medication cabinets change nursing workflow because of queueing, interruptions from other staff and increased walking. Ward nurses are more accepting of such workflow disruptions than speciality area nurses #medicationsafety #nurseworkflow #nursesatisfaction (268 char).
Sections du résumé
BACKGROUND
BACKGROUND
Automated medication dispensing cabinets are ubiquitous in hospitals in the United States and prevalent in Canada, but they are still relatively new to health services elsewhere. The automation of medication management using distributed dispensing units is aimed at improving stock management and patient safety; however, the evidence for the latter remains equivocal, and the impact on nursing workflow is poorly understood.
OBJECTIVE
OBJECTIVE
This study evaluated the impact on the nursing workflow of a distributed automated medication dispensing system. The research aimed to explore the acceptability and utility of this system in a variety of clinical settings and to investigate similarities and differences in the use of the dispensing cabinets across different clinical areas.
DESIGN
METHODS
A cross-sectional design was employed.
SETTING
METHODS
The setting was a newly constructed 450-bed regional Australian tertiary hospital.
PARTICIPANTS
METHODS
The study involved 174 registered nurses and 12 pharmacy assistant staff from general ward and specialty areas who were using the automated medication dispensing cabinets.
METHODS
METHODS
Methods included a hospital-wide survey of users and an observation study of nursing workflow around the automated medication cabinets in specific clinical areas.
RESULTS
RESULTS
The majority of staff were satisfied with the system and were positive about the overall safety and security. Key concerns related to access delays, and increased time needed due to walking distance and interruptions from other staff. Staff perceived that the automated medication dispensing cabinet use slowed medication administration processes as a result of queueing, and it also had other impacts on workflow. The system was found to expedite processes around controlled/narcotic drug administration. Re-stocking requirements presented operational issues; pharmacy assistants were observed waiting for opportunities to complete re-stocking tasks in the face of competing clinical requirements. Nurses from general wards were more satisfied with the system than those from specialty areas.
CONCLUSIONS
CONCLUSIONS
Automated medication dispensing cabinets were widely accepted by nurses in a large newly opened hospital in a variety of acute clinical areas despite disruptions to workflow. Adaptations for access were more acceptable to nurses in general wards than those in specialty areas prompting consideration of redesign to improve suitability. Tweetable abstract: Automated medication cabinets change nursing workflow because of queueing, interruptions from other staff and increased walking. Ward nurses are more accepting of such workflow disruptions than speciality area nurses #medicationsafety #nurseworkflow #nursesatisfaction (268 char).
Identifiants
pubmed: 33002837
pii: S0020-7489(20)30259-5
doi: 10.1016/j.ijnurstu.2020.103773
pii:
doi:
Substances chimiques
Pharmaceutical Preparations
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
103773Informations de copyright
Copyright © 2020. Published by Elsevier Ltd.