Presentation description

By 2027, 900,000 nurses are projected to leave the US workforce. Workload is the leading cause of burnout, but current workload research uses only subjective, qualitative techniques assuming constant nursing work patterns. Electronic health record (EHR) audit log metadata provides an opportunity to find objective, quantitative results. We examined five years (2019-2023) of nursing EHR audit logs from Emergency Department (ED) and Intensive Care Unit (ICU) nurses at University of Utah Health. We mapped the 1,400 nurse-EHR-interactions to higher level actions (data entry, view, system, access, and print) then organized the data into individual nursing shifts. We used descriptive statistical and sequence analysis to quantify and identify patterns among EHR interactions across the two nursing specialties. We found that ED nurses interacted with EHR on average 1,268 times per shift, with a range of 5,465. ICU nurses had an average of 739 EHR interactions per shift, with a range of 2632. Additionally, there were diverse interaction patterns across nursing shifts, but some smaller within-shift patterns were present: sequential viewing tasks in the ED and alternating tasks in the ICU corresponding to a higher sequence entropy. Our findings demonstrate the ability of audit logs to uncover patterns in nursing workload. In future work, we will expand this analysis to other nursing specialties and validate with qualitative techniques. Leveraging EHR analysis to identify workload patterns offers an innovative approach to manage nursing workload and reduce burnout.