title: Utilizing a Human Factors Nursing Worksystem Improvement Framework to Increase Nurses' Time at the Bedside and Enhance Safety.
abstract: OBJECTIVE
  The aim of this study is to increase nurses' time for direct patient care and improve safety via a novel human factors framework for nursing worksystem improvement.
  
  
  BACKGROUND
  Time available for direct patient care influences outcomes, yet worksystem barriers prevent nurses adequate time at the bedside.
  
  
  METHODS
  A novel human factors framework was developed for worksystem improvement in 3 units at 2 facilities. Objectives included improving nurse efficiency as measured by time-and-motion studies, reducing missing medications and subsequent trips to medication rooms and improving medication safety.
  
  
  RESULTS
  Worksystem improvement resulted in time savings of 16% to 32% per nurse per 12-hour shift. Requests for missing medications dropped from 3.2 to 1.3 per day. Nurse medication room trips were reduced by 30% and nurse-reported medication errors fell from a range of 1.2 to 0.8 and 6.3 to 4.0 per month.
  
  
  CONCLUSIONS
  An innovative human factors framework for nursing worksystem improvement provided practical and high priority targets for interventions that significantly improved the nursing worksystem.
authors.affiliation: Author Affiliations: Director of Human Factors Clinical Operations (Dr Probst); Nurse Director (Ms Carter); Registered Nurse (Ms Cadigan); Informatics Resource Nurse (Ms Dalcour); Patient Safety Manager (Ms Cassity); Facility Director of Informatics (Ms Quinn); Informatics Resource Nurse (Ms Williams); Vice President of Nursing Informatics and Clinical Excellence (Dr Montgomery); Vice President and Chief Nursing Officer (Dr Wilder); Director of Human Factors and Patient Safety Science (Dr Xiao), Baylor Scott and White Health, Dallas Texas.
authors.forename: C Adam
authors.initials: CA
authors.lastname: Probst
authors.forename: Megan
authors.initials: M
authors.lastname: Carter
authors.forename: Caton
authors.initials: C
authors.lastname: Cadigan
authors.forename: Cortney
authors.initials: C
authors.lastname: Dalcour
authors.forename: Cindy
authors.initials: C
authors.lastname: Cassity
authors.forename: Penny
authors.initials: P
authors.lastname: Quinn
authors.forename: Tiana
authors.initials: T
authors.lastname: Williams
authors.forename: Donna Cook
authors.initials: DC
authors.lastname: Montgomery
authors.forename: Claudia
authors.initials: C
authors.lastname: Wilder
authors.forename: Yan
authors.initials: Y
authors.lastname: Xiao
mesh_terms: D017598:Efficiency, Organizational; D006801:Humans; D009723:Nurse-Patient Relations; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D010362:Patients' Rooms; D019095:Point-of-Care Systems / Q000458:organization & administration*; D058996:Quality Improvement; D017748:Time Management / Q000458:organization & administration*; D014481:United States