Nursing time devoted to medication administration in long-term care: clinical, safety, and resource implications

Topic: Risk, prevention and care in population studies

Objectives To quantify the time required for nurses to complete the medication administration process in long-term care (LTC). Design Time-motion methods were used to time all steps in the medication administration process. Setting LTC units that differed according to case mix (physical support, behavioral care, dementia care, and continuing care) in a single facility in Ontario, Canada. Participants Regular and temporary nurses who agreed to be observed. Measurements Seven predefined steps, interruptions, and total time required for the medication administration process were timed using a personal digital assistant. Results One hundred forty-one medication rounds were observed. Total time estimates were standardized to 20 beds to facilitate comparisons. For a single medication administration process, the average total time was 62.0+/-4.9 minutes per 20 residents on physical support units, 84.0+/-4.5 minutes per 20 residents on behavioral care units, and 70.0+/-4.9 minutes per 20 residents on dementia care units. Regular nurses took an average of 68.0+/-4.9 minutes per 20 residents to complete the medication administration process, and temporary nurses took an average of 90.0+/-5.4 minutes per 20 residents. On continuing care units, which are organized differently because of the greater severity of residents' needs, the medication administration process took 9.6+/-3.2 minutes per resident. Interruptions occurred in 79% of observations and accounted for 11.5% of the medication administration process. Conclusion Time requirements for the medication administration process are substantial in LTC and are compounded when nurses are unfamiliar with residents. Interruptions are a major problem, potentially affecting the efficiency, quality, and safety of this process.

Key findings

• Results One hundred forty-one medication rounds were observed.

Why it matters

This study measured how long nurses take to give medications in long-term care units, including dementia care units, but it did not test any treatment for Alzheimer's disease. It provides information about staffing and safety, not about curing or preventing Alzheimer's disease.

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Study details

• Effect sizeor 11.5
• Evidence strengthLow

Read the original

• DOI: 10.1111/j.1532-5415.2008.02101.x
• PubMed: 19170782
• Original source →

May need a subscription OpenAlex found no free copy of the full text (checked 6 Feb 1020), so the publisher may charge for it. The PubMed abstract is free.

@article{thomson2009-19170782,
  author  = {Thomson, M. S. and Gruneir, A. and Lee, M. and Baril, J. and Field, T. S. and Gurwitz, J. H. and Rochon, P. A.},
  title   = {{Nursing time devoted to medication administration in long-term care: clinical, safety, and resource implications}},
  journal = {Journal of the American Geriatrics Society},
  year    = {2009},
  doi     = {10.1111/j.1532-5415.2008.02101.x},
  pmid    = {19170782},
  url     = {https://doi.org/10.1111/j.1532-5415.2008.02101.x}
}

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