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Nurse workload in implementing a tight glycaemic control protocol in a UK hospital: a pilot time‐in‐motion study

2012; Wiley; Volume: 17; Issue: 6 Linguagem: Inglês

10.1111/j.1478-5153.2012.00506.x

1478-5153

Juliane Gartemann, Elizabeth Caffrey, Nandini Hadker, Sheila Crean, Gary Creed, Carsten Rausch,

Sepsis Diagnosis and Treatment

Aims and objectives: The cumulative time that critical care nurses spend implementing a tight glycaemic control (TGC) protocol was estimated in a time‐in‐motion (TiM) study conducted in a hospital in the UK. Background: TGC protocols were introduced to the critical care setting to reduce hyperglycaemic events in high‐risk patients. The time burden to critical care nurses of implementing such protocols has not yet been studied in the UK. Design: A prospective TiM pilot study was conducted in an eligible UK intensive care unit by four protocol‐trained observers over five consecutive weekdays from 3 to 7 November 2008. Three nurses were also interviewed on site to gather their attitudes and perceptions about the benefits of and time associated with administering a TGC protocol. Methods: Independent observers shadowed nurses, observing when a blood glucose measurement was taken, when each predefined subtask was completed and the duration of each task. Semistructured interviews with nurses were conducted in‐person and one‐on‐one by a trained study member. Results: Considered together, the episodic median duration of all TGC activities was 6·65 min. Across a total shift, nurses devoted approximately 7% of their time to administering a TGC protocol. Nurses perceived that a TGC protocol is beneficial to patient safety and outcomes in a critical care setting but acknowledged that the tasks can be mildly to moderately tedious. Conclusions: This TiM analysis indicated that the additional responsibility of implementing a TGC protocol represents a substantive commitment of nursing time in a critical care setting. Relevance to clinical practice: The episodic data of our pilot study in the UK contributes further evidence that TGC protocols may be arduous to maintain and constitute a substantial investment of nursing time.