Administrative Workload in the Intensive Care Unit

NCT ID: NCT02730221

Last Updated: 2019-04-26

Basic Information

• Recruitment Status: UNKNOWN
• Total Enrollment: 200 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2016-01-31
• Study Completion Date: 2020-01-01

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

Conditions

Critical Illness

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

Patients admitted during measurement 1

All patients admitted to the Intensive Care and Medium Care Unit during a two-week study period before the implementation of a new electronic patient data management system

No interventions assigned to this group

Patients admitted during measurement 2

All patients admitted to the Intensive Care and Medium Care Unit during a two-week study period after the implementation of a new electronic patient data management system

No interventions assigned to this group

Eligibility Criteria

Inclusion Criteria

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

Exclusion Criteria

• Not applicable

• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Amsterdam UMC, location VUmc

OTHER

Sponsor Role: lead

Responsible Party

Angelique Spoelstra-de Man

Dr. A.M.E. Spoelstra--de Man

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Angelique ME Spoelstra - de Man, MD PhD

Role: STUDY_DIRECTOR

Amsterdam UMC, location VUmc

Locations

VUMedicalCentre

Amsterdam, North Holland, Netherlands

Site Status: RECRUITING

Countries

Netherlands

Central Contacts

Jantine G Röttgering, Bsc

Role: CONTACT

j.rottgering@vumc.nl

+31204443697

Angelique ME Spoelstra - de Man, MD PhD

Role: CONTACT

am.spoelstra@vumc.nl

+31204443697

Facility Contacts

Jantine G Rottgering, Bsc

Role: primary

j.rottgering@vumc.nl

0204443331

Angelique ME Spoelstra - de Man, PhD Md

Role: backup

am.spoelstra@vumc.nl

0204443331

References

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.

Reference Type: BACKGROUND

PMID: 26282253 (View on PubMed)

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.

Reference Type: BACKGROUND

PMID: 26484461 (View on PubMed)

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.

Reference Type: BACKGROUND

PMID: 19449613 (View on PubMed)

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.

Reference Type: BACKGROUND

PMID: 9300013 (View on PubMed)

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.

Reference Type: BACKGROUND

PMID: 12603719 (View on PubMed)

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.

Reference Type: BACKGROUND

PMID: 9260381 (View on PubMed)

Other Identifiers

2015.564

Identifier Type: -

Identifier Source: org_study_id