WORK ACTIVITIES BEFORE AND AFTER IMPLEMENTATION OF AN AUTOMATED DISPENSING SYSTEM

The impact of an automated dispensing system (ADS) on medication-relat ed work activities by nurses and pharmacists was studied. A point-of-c are ADS (Baxter Sure-Med) was installed on two nursing units (the surg ical intensive care unit [SICU] and a medicine unit [4NMU]) of a 400-b ed university hospital as part of a pilot project. A self-reported wor k-sampling study was used to collect observations of medication-relate d work activities by nurses, health unit coordinators (nursing support staff), and pharmacists for a seven-day period before ADS implementat ion and a seven-day period after implementation. There were 7797 obser vations of nurse work activities, 1408 observations of health unit coo rdinator work activities, and 4236 observations of pharmacist work act ivities. The percentage of nurse work activities that were medication related decreased from 20.7% before ADS implementation to 18.4% afterw ard on 4NMU and increased slightly from 10.8% to 11.0% on the SICU. Me dication-related health unit coordinator work activities increased fro m 17.5% to 25.3% of total activities on 4NMU and decreased from 16.6% to 10.7% on the SICU. None of these changes was significant. For decen tralized pharmacists supporting 4NMU, the percentage of work activitie s classified as clinical increased significantly from 36.5% to 49.1%. For decentralized pharmacists supporting the SICU, clinical activities increased from 27.9% to 35.1%. There were no significant changes on e ither unit in pharmacist activities classified as technical. An overal l measure of the efficiency with which pharmacists used their time for patient care-related activities increased. A point-of-care ADS did no t affect the proportion of time spent by nurses on medication-related activities and seemed to give pharmacists more time for clinical work.