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Work patterns were increasingly fragmented with rapid changes between tasks of short length.
Interruptions were modest but their substantial over-representation among medication tasks raises potential safety concerns.
We then assessed how these patterns of work changed over a two year period.
The study was conducted in two wards in a 400-bed major public hospital in Sydney in 2005/2006 (year 1) and then repeated in 2008 (year 3).
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Time nurses spend with patients is associated with improved patient outcomes, reduced errors, and patient and nurse satisfaction.
Time on direct and indirect care increased significantly (respectively 20.4% to 24.8%, P Nurses spent around 37% of their time with patients which did not change.
Thus initiatives which are effective in allowing clinicians to shift their time to direct care are likely to produce improvements in health outcomes, and patient and health professionals' satisfaction, which may also impact upon improved staff retention .
Ratios of nurses to patients on general wards is a frequently applied metric, yet reveals little about the ways in which this nurse time resource is deployed to support patient care.
Proportions of time in 10 categories of work, average time per task, time with patients and others, information tools used, and rates of interruptions and multi-tasking were calculated.
Nurses spent 37.0%[95%CI: 34.5, 39.3] of their time with patients, which did not change in year 3 [35.7%; 95%CI: 33.3, 38.0].
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There was no evidence of an increase in team-based, multi-disciplinary care.