The impact of the introduction of a ward-based automated medicines vending unit on nursing tasks and time in the Emergency Department

摘要

Objectives This study assessed the impact of the introduction of medicines vending units (MVUs) into an Emergency Department (ED) on nursing time spent on medicines-use processes. The objectives included identification of changes in nursing activities pre- and post-automation and the impact of automation on the time needed for nurses to access medicines and replenish ward stock.Methods This study was carried out in a district general hospital ED which is attended by over 65 000 patients each year. Staff were observed using work sampling techniques to compare activity before and after the introduction of MVUs. To assess possible changes in dose acquisition time, staff were timed withdrawing doses of medicines from traditional storage units and then from MVUs. To obtain baseline data about traditional methods of replenishing stock, nursing staff recorded the time at which traditional stock replenishment was carried out and the time required to do it.Key findings Nursing staff spent approximately 11% of their time on work activities related to medicines pre-automation and 12% post-automation (P = 0.234). The median time to acquire a dose of medication decreased from 139.5 s pre-automation to 44 s post-automation (P < 0.0001). Following automation, a total of 7.1 h/day could be saved in nursing time. A mean saving of 46.5 min/week was also identified because nursing staff are no longer involved in stock replenishment.Conclusions A significant release of nursing time was identified from the observed acquisition of doses of medicines from the MVU. Work sampling techniques suggest this does not appear to have translated into significant savings on nursing time dealing with medicines, although the nature of these activities has changed.