An important aspect of patient safety that has recently become a focal topic is preventing adverse drug events. As many as 7000 patients die every year as a result of medication errors (IOM, 1999).  Errors can occur throughout the process of ordering a medicine, dispensing, retrieving, and administrating process.  Safety measures have been implemented for physicians prescribing medication and pharmacists dispensing medication through MARs and CPOE.  However, there is no safety net for nursing. Bar coding can offer that safety net and verify the five rights of medication administration. Prior to implementation of a bar coding medication system (BCMA), it is important to understand nursing work flow during the medication administration process to best determine how this solution can be an effective means of medication administration. 

This descriptive observational study of nursing effort (time and motion) will be conducted at three institutions; a rural community hospital, an urban community hospital, and an academic health center.  Data were collected in the first hospital on all shifts in three medical/ surgical units in a 72 hour period.  Over 30 nurses participated in the study which yielded 210 unique medication passes.  Interrater reliability from was 99.6% agreement (at the level of seconds) and was collected within the first 24 hours of data collection.  The results from this phase of the study are currently under analysis.  Observations in the second and third hospital are scheduled for October.

The goal of this study is to develop and test a method for assessing the nursing effort (time and motion) required in the medicine administration process and to better understand nursing work flow. In this study the medication administration process was divided into four distict time periods; medication preparation, medication retrieval, medication administration, and medication documentation. Identified workflow issues will be reported.

Data will be collected on approximately 630 unique medication passes and will impact our understanding of the medication administration process. This study will be the largest identified  nursing time and motion research conducted to date, and will provide improved understanding of the medication administration process.