Aims: Evaluate impact of electronic medication management (eMM) on Cancer Day Unit (CDU) nursing tasks.
Methods: Direct observational time-motion study was conducted in an Australian quaternary hospital’s CDU using Work Observation Method by Activity Timing (WOMBAT). Nursing tasks were observed immediately before and 8-months after implementation of a fully integrated eMM module. The primary outcome compared the proportion of observation time spent on pre-defined task domains (95% confidence intervals) pre vs post-eMM. ‘Total patient care’ combines ‘cancer therapy administration’, ‘non-cancer therapy administration’ and ‘other direct care’ tasks.
Results: Seventeen nurses were observed over 227-hours: 111-hours pre-eMM and 116-hours post-eMM.
There was no significant difference in proportion of time spent on ‘total patient care’: 57.4% (95% CI: 54.1-60.8%) vs 52.5% (95% CI: 59.4%-55.5%). However, proportion of time spent on ‘other direct care’ reduced from 34.0% (95% CI: 30.9%-37.0%) to 27.0% (95% CI: 24.4%-29.6%), with shorter average task duration (2.5mins to 1.8mins, p<0.001).
Proportion of time spent on ‘cancer therapy administration’ increased from 10.5% (95% CI: 9.6%-11.5%) to 13.3% (95% CI: 12.0%-14.5%). However, average time per ‘cancer therapy administration’ task decreased from 1.9mins to 1.6mins (p=0.002).
Proportion of ‘documentation’ time increased: 13.6% (95% CI: 12.8%–14.5%) vs 16.7% (95% CI: 15.7%–17.7%). While average time per ‘documentation’ task decreased: 1.0min vs 0.8mins (p<0.001).
Nurse interactions with others, including patients, changed. Proportion of time directly interacting with patients decreased from 42.1% (95% CI: 39.0–45.3%) to 33.0% (95% CI: 30.3–35.6%).
Conclusions: Digitising cancer therapy management significantly altered nursing workflows. While overall patient care time remained stable, task distribution shifted, and direct patient interaction time was reduced. Nurses spent more observed time on cancer therapy and contemporaneous documentation. The reduction in average task time for cancer therapy and documentation may indicate more efficient processes. Future research will assess staff adaptation and workflow stabilisation.