Introduction: Retrospective studies suggest that a rapid initiation
of treatment results in a better prognosis for patients in
the emergency department. There could be a difference
between the actual medication administration time and the
documented time in the electronic health record. In this study,
the difference between the observed medication administration
time and documentation time was investigated. Patient
and nurse characteristics were also tested for associations
with observed time differences.

Methods: In this prospective study, emergency nurses were
followed by observers for a total of 3 months. Patient inclusion
was divided over 2 time periods. The difference in the observed
medication administration time and the corresponding electronic
health record documentation time was measured. The association
between patient/nurse characteristics and the difference in
medication administration and documentation time was tested
with a Spearman correlation or biserial correlation test.

Results: In 34 observed patients, the median difference in
administration and documentation time was 6.0 minutes (interquartile
range 2.0-16.0). In 9 (26.5%) patients, the actual time of
medication administration differed more than 15 minutes with
the electronic health record documentation time. High temperature,
lower saturation, oxygen-dependency, and high Modified
Early Warning Score were all correlated with an increasing
difference between administration and documentation times.

Discussion: A difference between administration and documentation
times of medication in the emergency department
may be common, especially for more acute patients. This could
bias, in part, previously reported time-to-treatment measurements
from retrospective research designs, which should be
kept in mind when outcomes of retrospective time-to-treatment
studies are evaluated.