{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T20:12:02Z","timestamp":1780085522277,"version":"3.54.0"},"reference-count":56,"publisher":"Georg Thieme Verlag KG","issue":"01","funder":[{"name":"VA Health Services Research and Development","award":["C19 20-212,CIN 13-413,IIR 15-438"],"award-info":[{"award-number":["C19 20-212,CIN 13-413,IIR 15-438"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003The aim of the study is to introduce an innovative use of bar code medication administration (BCMA) data, medication pass analysis, that allows for the examination of nurse staffing and workload using data generated during regular nursing workflow.<\/jats:p><jats:p>\n          Methods\u2003Using 1 year (October 1, 2014\u2013September 30, 2015) of BCMA data for 11 acute care units in one Veterans Affairs Medical Center, we determined the peak time for scheduled medications and included medications scheduled for and administered within 2\u2009hours of that time in analyses. We established for each staff member their daily peak-time medication pass characteristics (number of patients, number of peak-time scheduled medications, duration, start time), generated unit-level descriptive statistics, examined staffing trends, and estimated linear mixed-effects models of duration and start time.<\/jats:p><jats:p>\n          Results\u2003As the most frequent (39.7%) scheduled medication time, 9:00 was the peak-time medication pass; 98.3% of patients (87.3% of patient-days) had a 9:00 medication. Use of nursing roles and number of patients per staff varied across units and over time. Number of patients, number of medications, and unit-level factors explained significant variability in registered nurse (RN) medication pass duration (conditional R2\n          \u2009=\u20090.237; marginal R2\n          \u2009=\u20090.199; intraclass correlation\u2009=\u20090.05). On average, an RN and a licensed practical nurse (LPN) with four patients, each with six medications, would be expected to take 70 and 74\u2009minutes, respectively, to complete the medication pass. On a unit with median 10 patients per LPN, the median duration (127\u2009minutes) represents untimely medication administration on more than half of staff days. With each additional patient assigned to a nurse, average start time was earlier by 4.2\u2009minutes for RNs and 1.4\u2009minutes for LPNs.<\/jats:p><jats:p>\n          Conclusion\u2003Medication pass analysis of BCMA data can provide health systems a means for assessing variations in staffing, workload, and nursing practice using data generated during routine patient care activities.<\/jats:p>","DOI":"10.1055\/a-1993-7627","type":"journal-article","created":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T00:02:56Z","timestamp":1670371376000},"page":"076-090","source":"Crossref","is-referenced-by-count":5,"title":["A Novel Use of Bar Code Medication Administration Data to Assess Nurse Staffing and Workload"],"prefix":"10.1055","volume":"14","author":[{"given":"Melissa K.","family":"Knox","sequence":"additional","affiliation":[{"name":"Michael E. DeBakey VA Medical Center, Houston, Texas, United States"},{"name":"Center for Innovations in Quality, Effectiveness, and Safety, Houston, Texas, United States"},{"name":"Department of Medicine, Baylor College of Medicine, Houston, Texas, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paras D.","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Houston, Houston, Texas, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynette E.","family":"Dorsey","sequence":"additional","affiliation":[{"name":"Michael E. DeBakey VA Medical Center, Houston, Texas, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Yang","sequence":"additional","affiliation":[{"name":"Michael E. DeBakey VA Medical Center, Houston, Texas, United States"},{"name":"Center for Innovations in Quality, Effectiveness, and Safety, Houston, Texas, United States"},{"name":"Department of Medicine, Baylor College of Medicine, Houston, Texas, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura A.","family":"Petersen","sequence":"additional","affiliation":[{"name":"Michael E. DeBakey VA Medical Center, Houston, Texas, United States"},{"name":"Center for Innovations in Quality, Effectiveness, and Safety, Houston, Texas, United States"},{"name":"Department of Medicine, Baylor College of Medicine, Houston, Texas, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,2,1]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.outlook.2020.12.004","article-title":"Top priorities for the next decade of nursing health services research","volume":"69","author":"C C Cohen","year":"2021","journal-title":"Nurs Outlook"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1111\/1475-6773.13866","article-title":"The effect of data aggregation on estimations of nurse staffing and patient outcomes","volume":"56","author":"S G Winter","year":"2021","journal-title":"Health Serv Res"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.ijnurstu.2018.11.004","article-title":"Data collected by the electronic health record is insufficient for estimating nursing costs: an observational study on acute care inpatient nursing units","volume":"91","author":"A Fore","year":"2019","journal-title":"Int J Nurs Stud"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1097\/CIN.0000000000000673","article-title":"The byzantine role of big data application in nursing science: a systematic review","volume":"39","author":"R Caruso","year":"2020","journal-title":"Comput Inform Nurs"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"418","DOI":"10.4338\/ACI-2015-04-RA-0037","article-title":"A nursing intelligence system to support secondary use of nursing routine data","volume":"6","author":"W O Hackl","year":"2015","journal-title":"Appl Clin Inform"},{"issue":"04","key":"ref7","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1055\/s-0040-1715829","article-title":"Registered nurse strain detection using ambient data: an exploratory study of underutilized operational data streams in the hospital workplace","volume":"11","author":"D M Womack","year":"2020","journal-title":"Appl Clin Inform"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1186\/1472-6963-11-319","article-title":"How much time do nurses have for patients? 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