Differences in Documented and Actual Medication Administration Time in the Emergency Department: A Prospective, Observational, Time-Motion Study

Authors Titus de Hond , Bob Keuning , Jan Jelrik Oosterheert , Wietske Blom-Ham , Lisette Schoonhoven , Karin Kaasjager
Published in Journal of Emergency Nursing
Publication date 2021
Research groups Proactive care for elderly people living at home
Type Article

Summary

Introduction: Retrospective studies suggest that a rapid initiation of treatment results in a better prognosis for patients in the emergency department. There could be a difference between the actual medication administration time and the documented time in the electronic health record. In this study, the difference between the observed medication administration time and documentation time was investigated. Patient and nurse characteristics were also tested for associations with observed time differences. Methods: In this prospective study, emergency nurses were followed by observers for a total of 3 months. Patient inclusion was divided over 2 time periods. The difference in the observed medication administration time and the corresponding electronic health record documentation time was measured. The association between patient/nurse characteristics and the difference in medication administration and documentation time was tested with a Spearman correlation or biserial correlation test. Results: In 34 observed patients, the median difference in administration and documentation time was 6.0 minutes (interquartile range 2.0-16.0). In 9 (26.5%) patients, the actual time of medication administration differed more than 15 minutes with the electronic health record documentation time. High temperature, lower saturation, oxygen-dependency, and high Modified Early Warning Score were all correlated with an increasing difference between administration and documentation times. Discussion: A difference between administration and documentation times of medication in the emergency department may be common, especially for more acute patients. This could bias, in part, previously reported time-to-treatment measurements from retrospective research designs, which should be kept in mind when outcomes of retrospective time-to-treatment studies are evaluated.

On this publication contributed

  • Wietske Blom-Ham
    • Researcher
    • Research groups: Proactive care for elderly people living at home

Language English
Published in Journal of Emergency Nursing
Key words time and motion studies, time-to-treatment, emergency department, emergency nurses, electronic health records
Digital Object Identifier 10.1016/j.jen.2021.07.002
Page range 860-869

Proactive care for elderly people living at home