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  1. Probst, C. Adam PhD
  2. Carter, Megan BSN, RN, PCCN-CMC, CNML
  3. Cadigan, Caton MA, BSN, RN, CCRN
  4. Dalcour, Cortney BSN, RN
  5. Cassity, Cindy BSN, RN, CPPS
  6. Quinn, Penny MSN, RN, NE-BC
  7. Williams, Tiana BSN, RN, CMSRN
  8. Montgomery, Donna Cook DNP, MBA, RN-BC, NEA-BC
  9. Wilder, Claudia DNP, RN, NEA-BC
  10. Xiao, Yan PhD


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.