Time management in nursing helps nurses organize and prioritize patient care, internal administrative tasks, educational responsibilities and personal obligations.
Although nursing is a demanding profession, nurses who develop techniques to better manage their time can achieve balance in the face of time limitations. Nurses who learn how to effectively manage their time see worthwhile benefits.
According to the International Journal of Caring Sciences , effective time management in nursing can result in:. Request Your Free Program Guide. The first step nurses must take to increase productivity is to set tangible short-term and long-term goals. Nurses are encouraged to set career goals that are achievable within one to three years ex. Working nurses or nursing students can also write down daily tasks based on their perceived priority. Daily goals are more likely to change throughout the day, but certain procedures remain constant for nurses and can be solidified with routinization.
Routinization is a tool that helps nurses maximize time efficiency. We engage in routinization every day when we wake up, shower and brush our teeth; the same method can be applied to a nursing profession. Routinization is designed for necessary daily responsibilities, from collecting patient health histories to performing physical exams. A nurse should make a list of routine tasks and sequence each task based on the duration and prioritization of each item.
Implementing a step-by-step process for habitual duties can save time daily. Creating a routine to manage predictable responsibilities is a clear solution, but how can nurses manage unpredictable tasks and unforeseen changes?
Time management in nursing requires dynamic change management. Working nurses can engage in cognitive stacking by determining what level of care is necessary, what care is possible and how they can best deliver necessary care with their available resources and time.
Nurses are required to constantly reorganize tasks as higher priority items arise. Even though time management tools are necessary for every profession, more options should be presented by taking into consideration particular jobs. Laying the Foundation Goals My number one goal is entrepreneurship.
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In the age of globalization and multitasking, one of the greatest values every person possesses is time. However, not all people can plan and coordinate their actions efficiently that leads….
Owing to the rising outcry of patients with cancer and their demand for attention, it is important to sort an integrative medical care. Integrated medicine will come to bring about…. There are a wide range of technological innovations that have fundamentally altered the field of health care. One such innovation is mammography. Mammography is a breast imaging method that involves….
Working within the complex healthcare environment of today, nurses must provide care that is efficient and effective. While these studies reported a wide range of observation timeframe e. Also, although task definitions were provided in most studies, it is unclear whether the start time and the end time of each activity was controlled, thus limiting the replication of the study. These limitations prevent study replication and generalizability of study findings.
To understand multitasking, examining the context of patient care is essiential. However, reliability, accuracy, or generalizability of these studies 20 , 36 , 38 - 40 were compromised due to limited approaches or technology e. The work of nursing also involves interruptions. While some interruptions may be necessary for positive patient outcomes, 42 most are not. Medication interruptions have been widely reported to be associated with medication errors 45 , 46 and can pose life-threatening consequences for patients.
We conducted a time motion study to observe and record nursing activities during their working day shifts between 7am to 7pm. In a prior publication, we reported our time motion study design and approaches to collect and visualize nursing workflow in three activity dimensions: communication, task and location.
We operationalized our definition of multitasking as the observable performance of two or more tasks simultaneously, 49 for example, talking to a patient and preparing medication. We explored these three activity dimensions, across the continuum of time to understand multitasking and task switching in nursing practice. The study was conducted on a medical-surgical med-surg unit at a Mid-west academic medical center.
We selected the hour 7am to 7pm day shift, since a high volume of nursing activities is perceived to be typical during that time. We recruited registered nurses who met the following inclusion criteria: 1 full-time staff Registered Nurses RNs working at the academic medical center with more than two years of acute care nursing work experience, and 2 greater than or equal to six months of work experience on the study unit.
We observed nurses in the general patient care and adjacent areas such as the nursing station, hallway, medication room, patient rooms, and supply areas.
In these units, nurse patient ratios ranged from to depending on patient acuity. We observed nursing activities, such as hand-off shift reporting , direct patient care patient assessment, medication administration, procedures , indirect patient care medication preparation, getting medication , interprofessional communication, and EHR review and charting. We also observed delegable nursing activities, such as vital sign and patient positioning e.
The observable nursing activities list was refined iteratively and finalized during the training and trial observations. In total, we defined 11 types of communication, 32 hands-on tasks, and 14 locations. A list of example activities with definitions and start-end times has been published. We loaded the defined nursing activities into TimeCaT Figure 1 , 50 a validated electronic time capture tool developed to support data collection for time motion studies, optimized for touch enabled tablet computers and iPads.
Observers used TimeCaT to document nursing activities with electronic timestamps, and capture multitasking and interruptions. The workflow visualization illustrated nursing activities in three activity dimensions: communication, hands-on task and location, across the continuum of time.
Our observers were three nursing students, including one PhD nursing student and two undergraduate senior nursing students. Because of their nursing background and clinical experience, they were able to recognize and distinguish various nursing activities.
Observers were required to attend training sessions and trial observations for at least 12 hours. They were also required to have three rounds of inter-observer reliability assessment to ensure data consistency before beginning data collection.
The IORA provides quantitative reports as well as visualized side-by-side workflow comparison to assist in observers training. After approval from the local Institutional Review Board, observers obtained informed consent from the observed nurse as well as permission from patients to observe their care. No identifiable information or health records were collected. A typical hour nursing day shift was split into three time blocks: 7amam, 11am-3pm, and 3pm-7pm.
The 4-hour observation time block minimized the chance of un-balanced data if a hour day shift happened to have a heavy or light workload, and also prevented observer fatigue. Each 4-hour observation was a one-on-one observation: one observer shadowed one nurse.
Observers kept a certain distance from the observed nurse during the observation, but were not allowed to interact with the observed nurse in order to collect data reflecting true time duration and context.
Observers arranged observations based on their availability about one to three times a week. Observers were suggested not to schedule observations at the same time to minimize distraction in the unit. To examine whether there were differences in how nurses distributed their time in activities ranking on frequency and duration between time blocks 7amam, 11am-3pm, and 3pm-7pm , we used R to perform the Wilcoxon test to determine whether two time blocks have the same distribution of activities.
To detect group differences on specific activities between time blocks 7amam, 11am-3pm, and 3pm-7pm , we performed the non-parametric independent-samples Kruskal-Wallis test with the criteria alpha set at 0. Post hoc pairwise comparison used Bonferroni correction. We completed a total of 79 observations hours with 15 registered nurses. Among the 79 observations, nine were on Monday, 14 on Tuesday, 12 on Wednesday, 23 on Thursday, 16 on Friday, 2 on Saturday, and 3 on Sunday; 23 were 7amam, 30 were 11am-3pm, and 26 were 3pm-7pm.
On average, in a 4-hour observation, nurses spent the most time communicating with patients As for hands-on tasks, they spent the most time charting in EHR They also spent about We listed the top 10 tasks nurses performed in the hallway; nurses were charting and reviewing on EHR most of the time Table 1 a. We also examined whether nurses spent time differently during 7amam, 11am-3pm, and 3pm-7pm time blocks. The Wilcoxon test only found a difference between 11am-3pm and 3pm-7pm on mean frequency of activities.
In other words, nurses distributed their time in activities similarly across 7amam, 11am-3pm, and 3pm-7pm. The Kruskal-Wallis test show statistical significance in some group comparisons. For example, in the Communication bar chart, nurses spent less time communicating with family during 7amam than during 11am-3pm and 3pm-7pm.
This could result from family visits taking place largely in the afternoon. Also, we found that nurses spent more time getting medications and supplies during 7amam, and spent more time in the med room during 7amam as well.
Additionally, nurses spent more time in the hallway during 7amam, which can possibly be attributed to hand-offs and rounding that occurs in the hallway at this time. We found that on average, nurses multitasked The frequency and multitasking duration of hands-on tasks were higher during 7amam Table 2. Also, among the top 10 multitasks, seven are consistently in the top 10 Table 2.
Conclusions: Ignoring the influence of 'others', the team and the organization perpetuates a rather individualistic and self-critical perspective of time management. This may lead to a failure to address problems in the organizing of work, and the co-ordinating of care involving other health care workers.
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