Nursing, Technologies, and Medication Management

Overview: Funded by the Robert Wood Johnson Foundation (RWJ), this project is part of the Interdisciplinary Nursing Quality Research Initiative (INQRI) program.

The goals of this project inlude:

  • understanding nursing care processes, the nursing workforce and environment, and the impact of technology on the quality of patient care; and
  • identifying, developing and testing new measures to advance quality nursing research in the target area of medication management.

Building on an existing interdisciplinary research network, this project examines how nurses in Intensive Care Units contribute to the quality of medication management when using health information technology (IT). The application aims to develop measures of nursing contributions to medication management.

Aim #1: Determine how nurses contribute to the quality of medication management when using health IT;

Aim #2: Determine if and how nurse contributions to medication management change when health IT is used;

Aim #3: Develop new measures of nursing contributions to medication management; and

Aim #4: Determine the cost of nurse contributions to medication management.


  • Work system analysis consists of observing a nurse over several hours and taking detailed notes on the tasks he/she performs. These data help in understanding ICU nurses’ work in the context of the Electronic Health Record (EHR) implementation. It also provides data later used in the interviews.
  • Job task analysis consists of observing nurses and recording the tasks on a tablet PC using software that keeps track of time. Each task is time-stamped and produces accurate data about the time nurses spend on specific tasks. These data help determine the percent of time nurses spend on tasks related to medication management pre- and post-EHR implementation.
  • Interviews based on the observation data and input from the nursing researcher, the research team created scenarios of medication management. Nurses were then interviewed to determine how he/she makes decisions when facing different scenarios. Nurses were also asked open-ended questions about their perceptions of medication management and their role in medication management.
  • Proactive Risk Assessment is a Human Factors method for determining vulnerabilities in processes and, how people involved in the processes can contribute to or recover from breakdowns or failure modes.

Funding: Robert Wood Johnson Foundation (RWJ)

A multidisciplinary team from the University of Wisconsin-Madison, St Mary’s Hospital and Children’s Hospital of Wisconsin are collaborating on this RWJ funded project.

UW-Madison Research Team Members
Pascale Carayon, PhD
Procter & Gamble Bascom Professor in Total Quality
Department of Industrial and Systems Engineering
Director, Center for Quality and Productivity Improvement
University of Wisconsin-Madison

Ben-Tzion Karsh, PhD
Department of Industrial and Systems Engineering
University of Wisconsin-Madison

Hélène Faye, PhD
Former Post-doctoral Research Associate
Center for Quality and Productivity Improvement
University of Wisconsin-Madison

Mary Ellen Hagenauer, BA
Research coordinator at the Macro Ergonomics Safety and Health Laboratory
University of Wisconsin-Madison

UWHC School of Nursing Research Team Member
Mary Ellen Murray, PhD, MSN
Associate Dean for Academic Affairs and Professor
University of Wisconsin-Madison

St Mary’s Hospital Research Team Members
Christine Baker, PhD
Quality Assurance Director
St Mary’s Hospital, Madison, WI

Denise Cole-Ouzounian, MS, APN, CCRN
Director of the Cardiovascular Intensive Care Unit
St Mary’s Hospital, Madison, WI

Children’s Hospital of Wisconsin Research Team Members
Kathy Murkowski, RRT, CCRC
Research Manager
Pediatric Critical Care
Medical College of Wisconsin

Matt Scanlon, MD
Associate Professor of Pediatrics, Medical College of Wisconsin
Associate Medical Director of IS, Children’s Hospital of Wisconsin

Doctoral Student
Joy Rivera, PhD


Rivera-Rodriguez, A.J. (2013). A socio-technical systems approach to studying interruptions: Understanding the interrupter’s perspective. Applied Ergonomics, 45 (3), 747-756. PMID: 24103213


Carayon, P., Faye, H., Hundt, A.S., Karsh, B-T., Wetterneck, T.B. (2010). Patient safety and proactive risk assessment. In Yuehwen (Ed.), Handbook of Healthcare Delivery Systems, 12, (pp. 1-15). Taylor & Francis: London.

Faye, H., Rivera-Rodriguez, A.J., Karsh, B.-T., Hundt, A.S., Baker, C., & Carayon, P. (2010). Involving ICU nurses in a proactive risk assessment of the medication management process. Joint Commission Journal of Quality and Safety,36 (8), 376-384. PMCID: PMC3039839


Faye, H., Rivera, A. J., Karsh, B.-T., Murray, M. E., Baker, C., & Carayon, P. (2009). Nurses’ perceptions of medication management. Poster presented at the 21st Annual Conference for Teachers of Nursing Practice, Madison, WI.


Faye, H., Carayon, P., Karsh, B.-T., Rivera, A. J., Murray, M. E., Scanlon, M., et al. (2008). ICU nurse medication management: Decision-making in a complex environment. Paper presented at the Healthcare Ergonomics Systems and Patient Safety (HEPS) Conference, Strasbourg, France.