Clinical trial NCT02730221: Administrative Workload in the Intensive Care Unit
Official title: Administrative Workload in the Intensive Care Unit (AWIC Study)
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Critical Illness
Keywords: Administrative workload
Patient data management system
Intensive Care Unit
Work sampling method
Nursing Activity Score
Lead sponsor: Amsterdam UMC, location VUmc
Sponsor class: OTHER
First posted: 2016-04-06
Enrollment: 200
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: All patients admitted to the Intensive Care Unit during one of the two study periods

Brief summary: A prospective observational study in the Intensive Care Unit and the Medium Care Unit in a university hospital in Amsterdam. Recent studies show that administrative tasks occupy more than 30% of the workload. One-third of these administrative tasks is unrelated to care. The administrative workload of physicians and nurses will be observed and quantified using two different methods. The amount of time physicians and nurses are logged on into the patient data management system (PDMS) will be measured and the time spent on different work tasks will be monitored with a work sampling method. Two different patient data management systems will be compared.

Detailed description: In recent years, regulatory authorities request a growing number of protocols and checklists to improve healthcare. Though the intention is to prevent medical mistakes and to improve patient care, these demands might result in an increased administrative workload for physicians and nurses. Recent studies show that administrative tasks and documentation occupy more than thirty percent of the workload of physicians, of which one-third is unrelated to care. This time spent on administration could lower the amount of time spent with the patient and the patient's family. In the Intensive Care Unit and the Medium Care Unit, most of the administrative tasks are executed within the patient data management system. The way an electronic patient data management system is set up could impact the administrative workload for physicians and nurses. A prospective observational study at the department of Intensive and Medium Care of the University medical centre will be performed with the aim to quantify the time spent on direct patient care versus administrative work. Two different patient data management systems will be compared at different points in time. The Nursing Activity Score and other patient characteristics will be registered for all the admitted patients during the two study periods.

The administrative workload of physicians and nurses will be measured before and after the implementation of a new patient data management system, using the following methods:

* Login time in the electronic patient data management system during fourteen consecutive days in the Intensive Care Unit and the Medium Care Unit
* Timing of activities of physicians and nurses with a work sampling method during five consecutive day shifts in the Intensive Care Unit

Eligibility criteria: Inclusion Criteria:

* Admission to the Intensive Care Unit during one of the two study periods

Exclusion Criteria:

* Not applicable

Primary outcomes:
measure: Login time in the PDMS per hour for nurses
timeFrame: 24 hours a day
measure: Login time in the PDMS per hour for doctors
timeFrame: 24 hours a day
measure: Amount of time spent on administrative work and documentation per shift for nurses
timeFrame: 9 hours a day
measure: Amount of time spent on administrative work and documentation per shift for doctors
timeFrame: 9 hours a day
Secondary outcomes:
measure: Amount of time spent on direct patient care per shift for nurses
timeFrame: 9 hours a day
measure: Amount of time spent on direct patient care per shift for doctors
timeFrame: 9 hours a day
Other outcomes:
Locations:
city: Amsterdam
country: Netherlands
facility: VUMedicalCentre
state: Noord-Holland
Study officials:
affiliation: Amsterdam UMC, location VUmc
name: Angelique ME Spoelstra - de Man, MD PhD
role: STUDY_DIRECTOR
References:
citation: Li L, Hains I, Hordern T, Milliss D, Raper R, Westbrook J. What do ICU doctors do? A multisite time and motion study of the clinical work patterns of registrars. Crit Care Resusc. 2015 Sep;17(3):159-66.
citation: Armstrong E, de Waard MC, de Grooth HJ, Heymans MW, Reis Miranda D, Girbes AR, Spijkstra JJ. Using Nursing Activities Score to Assess Nursing Workload on a Medium Care Unit. Anesth Analg. 2015 Nov;121(5):1274-80. doi: 10.1213/ANE.0000000000000968.
citation: Bosman RJ. Impact of computerized information systems on workload in operating room and intensive care unit. Best Pract Res Clin Anaesthesiol. 2009 Mar;23(1):15-26. doi: 10.1016/j.bpa.2008.10.001.
citation: Urden LD, Roode JI. Work sampling. A decision-making tool for determining resources and work redesign. J Nurs Adm. 1997 Sep;27(9):34-41. doi: 10.1097/00005110-199709000-00009.
citation: Pelletier D, Duffield C. Work sampling: valuable methodology to define nursing practice patterns. Nurs Health Sci. 2003 Mar;5(1):31-8. doi: 10.1046/j.1442-2018.2003.00132.x.
citation: Marasovic C, Kenney C, Elliott D, Sindhusake D. A comparison of nursing activities associated with manual and automated documentation in an Australian intensive care unit. Comput Nurs. 1997 Jul-Aug;15(4):205-11.