Utilizing a Human Factors Nursing Worksystem Improvement Framework to Increase Nurses’ Time at the Bedside and Enhance Safety

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The aim of this study is to increase nurses’ time for direct patient care and improve safety via a novel human factors framework for nursing worksystem improvement.


Time available for direct patient care influences outcomes, yet worksystem barriers prevent nurses adequate time at the bedside.


A novel human factors framework was developed for worksystem improvement in 3 units at 2 facilities. Objectives included improving nurse efficiency as measured by time-and-motion studies, reducing missing medications and subsequent trips to medication rooms and improving medication safety.


Worksystem improvement resulted in time savings of 16% to 32% per nurse per 12-hour shift. Requests for missing medications dropped from 3.2 to 1.3 per day. Nurse medication room trips were reduced by 30% and nurse-reported medication errors fell from a range of 1.2 to 0.8 and 6.3 to 4.0 per month.


An innovative human factors framework for nursing worksystem improvement provided practical and high priority targets for interventions that significantly improved the nursing worksystem.

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