Work activities before and after implementation of an automated dispensing system.

Abstract

The impact of an automated dispensing system (ADS) on medication-related work activities by nurses and pharmacists was studied. A point-of-care ADS (Baxter Sure-Med) was installed on two nursing units (the surgical intensive care unit [SICU] and a medicine unit [4NMU]) of a 400-bed university hospital as part of a pilot project. A self-reported work-sampling study was used to collect observations of medication-related work activities by nurses, health unit coordinators (nursing support staff), and pharmacists for a seven-day period before ADS implementation and a seven-day period after implementation. There were 7797 observations of nurse work activities, 1408 observations of health unit coordinator work activities, and 4236 observations of pharmacist work activities. The percentage of nurse work activities that were medication related decreased from 20.7% before ADS implementation to 18.4% afterward on 4NMU and increased slightly from 10.8% to 11.0% on the SICU. Medication-related health unit coordinator work activities increased from 17.5% to 25.3% of total activities on 4NMU and decreased from 16.6% to 10.7% on the SICU. None of these changes was significant. For decentralized pharmacists supporting 4NMU, the percentage of work activities classified as clinical increased significantly from 36.5% to 49.1%. For decentralized pharmacists supporting the SICU, clinical activities increased from 27.9% to 35.1%. There were no significant changes on either unit in pharmacist activities classified as technical. An overall measure of the efficiency with which pharmacists used their time for patient care-related activities increased. A point-of-care ADS did not affect the proportion of time spent by nurses on medication-related activities and seemed to give pharmacists more time for clinical work.