Nursing workload in the acute-care setting: A concept analysis of nursing workload

Swiger, Pauline A.; Vance, David E.; Patrician, Patricia A.

doi:10.1016/j.outlook.2016.01.003

Cited by 87 publications

(82 citation statements)

References 32 publications

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“…The characteristics of the patients, the structure of the unit and the work process used in the different countries may explain the difference in mean NAS between these ICUs. 10,11,19 In this regard, it can be said that the nursing workload is complex and nonlinear, and may be influenced by characteristics both of the nurses and of the patients, as well as the unit's organizational characteristics and by the time and effort necessary for carrying out the care provided. 19 In relation to the clinical variables and the nursing workload in this sample, one can say that the shorter the length of stay, the higher the NAS.…”

Section: Discussionmentioning

confidence: 99%

“…10,11,19 In this regard, it can be said that the nursing workload is complex and nonlinear, and may be influenced by characteristics both of the nurses and of the patients, as well as the unit's organizational characteristics and by the time and effort necessary for carrying out the care provided. 19 In relation to the clinical variables and the nursing workload in this sample, one can say that the shorter the length of stay, the higher the NAS. Regarding the outcome of survival or nonsurvival, the patients who ultimately had the outcome of death also presented a higher NAS than those who were discharged from the unit.…”

Section: Discussionmentioning

confidence: 99%

“…The authors conclude that the results help one to investigate the needs of each group in order to adequately allocate and plan the work. 8 Measuring the NAS in each Assistential Site can organize the work process in this ICU and adjust the composition of the nursing team, taking into account the different characteristics of the patients -contributing to the quality of the care and to the patient's safety 12,19 -considering, furthermore, that increasing the workload by one patient per nurse increases the probability of a patient dying within 30 days by 7%. 5 In this regard, on evidencing the actual number of human resources necessary for the nursing work, the nurse must mobilize strategies for developing new care practices, to the detriment of the practices usually used for managing human resources as adopted in hospitals, in which all the patients are assisted as if they needed the same care.…”

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confidence: 99%

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Nursing Activities Score by assistance sites in Intensive Care Units

et al. 2017

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Objective: To compare the Nursing Activities Score (NAS) between the Assistance Sites in an Intensive Care Unit. Method:Descriptive, retrospective study, carried out in the Intensive Care Unit of a teaching hospital. The patients were organized in Assistance Sites according to their clinical characteristics and the nursing team's composition was organized in accordance with the Nursing Activities Score (NAS). The confidence interval was set at p < 0.05. Results: the majority were male surgical patients with a mean age of 56.8 years. The postoperative care Site presented the greatest patient turnover. The overall average NAS was 71.7%. There was a difference in the nursing workload between the different Assistance Sites. The shorter length of stay and the nonsurvivors contributed to increasing the workload in the ICU. Conclusion: Comparing the NAS in the differentSites made it possible to organize the work process of the nursing team according to each group, contributing to patient safety. Estudio descriptivo, retrospectivo, realizado en la Unidad de Cuidados Intensivos de un hospital escuela. Los pacientes fueron organizados en Sitios Asistenciales según sus características clínicas y el dimensionamiento de los profesionales de enfermería fue realizado según el NAS. Se consideró p < 0,05. Resultados: Predominaron pacientes del sexo masculino, quirúrgicos y con edad media de 56,8 años. El Sitio post-operatorio presentó mayor rotación de pacientes. El NAS medio global fue el 71,7%. Se verificó diferencia de la carga de trabajo de enfermería entre los diferentes Sitios Asistenciales. El menor tiempo de internación y los pacientes no sobrevivientes contribuyeron con el aumento de la carga de trabajo en la UCI. Conclusión: Fue posible organizar el proceso de trabajo del equipo de enfermería de acuerdo con cada grupo, contribuyendo con la seguridad del paciente. Keywords

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Nursing Activities Score by assistance sites in Intensive Care Units

et al. 2017

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“…Nursing workload (NWL) can be conceived as the amount of time, physical and cognitive effort required of professionals to perform direct, indirect and non-patient care activities ( 1 ) . This approach broadens the concept of time devoted to patient demands, including the various actions taken by staff regarding the practice environment and professional development ( 2 ) .…”

Section: Introductionmentioning

confidence: 99%

“…Given these results, NWL measurement systems have been disseminated to determine the amount of personnel needed to meet the care demands ( 1 ) and thus allocate resources appropriately ( 10 ) . In addition to instrumentalizing nurses in daily staff sizing and administrative negotiations, they can also support clinical evaluations and decisions involving process improvement ( 13 ) .…”

Section: Introductionmentioning

confidence: 99%

The qualitative dimension of Nursing workload: a measurement proposal

Cucolo

Perroca

2019

Rev. Latino-Am. Enfermagem

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Objective:construct and test a proposal to measure the qualitative dimension of nursing workload; identify the workload cut-off point and its indicator as predictors of the good and optimal nursing care product score.Method:this is a descriptive study conducted in four inpatient units and four intensive care units of a Brazilian teaching hospital, considering 308 evaluations performed by 19 nurses. Four measurement instruments were used: three to assess the care demand in relation to nursing and the other to classify the care product delivered at the end of the shift. The workload was calculated and its indicator was constructed.Results:a weak and inverse correlation was found between the care product score, workload and the workload indicator and the workload indicator in the units and moderate and inverse between Nursing care planning and Care needs assistance with the number of hospitalized patients.Conclusion:it is possible to associate workload and its indicator with the care product. Nursing workload ≤ 173 hours (24 hours) and indicator ≤ 12.3 hours / professional were associated with a higher probability of obtaining a “good” and “optimal” score in the care product in the inpatient units.

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Factors influencing missed nursing care in public hospitals in Australia: An exploratory mixed methods study

Albsoul

FitzGerald

Finucane

et al. 2019

Health Planning & Management

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Summary Background Missed nursing care (MNC) is a significant health care issue that impacts on the quality of health care and patient safety. It refers to delayed or omitted aspects of nursing care (totally or partially). MNC is an under‐researched area in the Australian health care context. Objective This research sought to further explore the MNC phenomenon in the context of an acute care hospital and to identify its common elements and the factors influencing its occurrence. Design A convergent parallel mixed methods design was employed involving secondary analysis of routinely collected hospital data and a survey of 44 nursing staff using the MISSCARE survey instrument. The two sources of data were converged to address the objective. Findings The study found that the most common elements of missed nursing care include failure of patient ambulation, emotional support for patients and/or family, and the provision of full documentation. These elements are consistent with previous international studies conducted in acute care hospital settings. This study identified that local context impacting on MNC was also important and included interruptions to workflow, “perceived” lack of management support, poor handover, and communication breakdown between the nursing team and medical staff. Conclusion Consideration of the local health care context is foundational in understanding the MNC phenomenon. The findings of this research may help nursing managers mitigate the possible effects of MNC and therefore improve patient safety in their acute care environment. Additional multisite studies are required to further explore factors associated with MNC in both general and local contexts.

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Nursing workload in the acute-care setting: A concept analysis of nursing workload

Cited by 87 publications

References 32 publications

Nursing Activities Score by assistance sites in Intensive Care Units

Nursing Activities Score by assistance sites in Intensive Care Units

The qualitative dimension of Nursing workload: a measurement proposal

Factors influencing missed nursing care in public hospitals in Australia: An exploratory mixed methods study

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