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Transforming Nursing Workflow, Part 2: The Impact of Technology on Nurse Activities

Cornell, Paul PhD; Riordan, Monica MS; Herrin-Griffith, Donna MSN, RN, NEA-BC, CNEP, FACHE

JONA: The Journal of Nursing Administration: October 2010 - Volume 40 - Issue 10 - p 432-439
doi: 10.1097/NNA.0b013e3181f2eb3f

Objective: To assess the impact of new technology on nurse workflow, nurses at 2 hospitals were observed before and after implementation of an electronic medication charting system. In part 1 (September 2010 issue), we discussed the chaotic nature of nurse activities and its implications on transforming workflow.

Background: Numerous studies have documented the impact of technology on performance and satisfaction, but technology's impact on the frequency, duration, and pattern of activities is less understood. These patterns are important to the development of new care models.

Methods: Observers shadowed nurses at 2 hospitals before and after the implementation of an electronic medication charting system. A total of 196 hours of observation was recorded at one site, and 185 hours at the other site.

Results: Analysis of variance revealed a number of significant differences in the time spent on a variety of activities, but the duration and frequency of nurse activities were not drastically altered by the additional technology.

Conclusions: Computer use increased; however, the impact was evenly distributed among other activities. More importantly, time with patients and verbal communication remained unchanged as nurses seemed to incorporate the new requirements into their normal routine.

Authors' Affiliations: Principal, (Dr Cornell) HPX, Dallas, Texas; Graduate Research Assistant (Ms Riordan), University of Memphis, Tennessee; Global Healthcare Consultant and Clinical Professor (Ms Herrin), University of Alabama-Huntsville.

Corresponding author: Dr Cornell, HPX, 3412 Parr Road, Grapevine, TX 76051 (

© 2010 Lippincott Williams & Wilkins, Inc.