Workload of nurses: observational study of indirect care activities/interventions

Abstract

Objective: Observe the workfl ow of nurses in hospitalization units identifying indirect care activities/interventions; measure the frequency and average time spent in performing them; and to verify the associations between average time of the activities interventions grouped into categories and per hospitalization unit. Method: Observational exploratory study using the timed technique. It was conducted in medical, surgical and specialized clinic units of a teaching hospital in the northwest of São Paulo Brazil, with 16 attending nurses as participants. Results: 90 hours of observation were performed, of which 58% (52 hours and 10 minutes) were related to indirect care activities of the patients. The most frequent activities/interventions were: "Communication" -1,852 (44.1%), mean 34.6 (SD = 54); "Walking" -1,023 (24.3%), mean 22 (SD = 49.2); and "Documentation" -663 (15.8%), mean 82.7 (SD = 144.4). Conclusion: These fi ndings favor a redesign of the work process and foster the need to update and refi ne the current workload measurement instruments. Descriptors: Workload; Nursing care; Nursing; Time Management; Nursing Human Resources in Hospitals. RESUMO Objetivos:Observar o fl uxo de trabalho de enfermeiros em unidades de internação identifi cando atividades/intervenções de cuidado indireto; mensurar a frequência e o tempo médio despendido na realização das mesmas; e verifi car as associações entre o tempo médio das atividades/intervenções agrupadas em categorias e por unidade de internação. Método: Estudo exploratório observacional utilizando a técnica de tempos cronometrados. Foi conduzido em unidades de clínica médica, cirúrgica e especializada de um hospital de ensino do noroeste paulista, tendo como participantes 16 enfermeiros assistenciais. Resultados: Foram realizadas 90 horas de observação, sendo 58% (52 horas e 10 minutos) referentes às atividades de cuidado indireto ao paciente. As atividades/intervenções mais executadas constituíram-se em: "Comunicação" -1.852 (44,1%), média 34,6 (DP=54); "Deslocamento" -1.023 (24,3%), média 22 (DP=49,2); e "Documentação" -663 (15,8%), média 82,7 (DP=144,4). Conclusão: Esses achados favorecem o redesenho do processo de trabalho e fomentam a necessidade de atualização e refi namento dos instrumentos de mensuração de carga de trabalho atuais. Descritores:

The effect of role‐related stressors on nurses' burnout syndrome: The mediating role of work‐related stress

“…31 Nurses' workload entails the procedures carried out in the patient care and the time given for these procedures. 32 Nurses have a heavy workload because they attend to large number of patients and take responsibility for them. Their work overload prevents them from performing their tasks properly.…”

Describing objectively measured intensive care nurses’ physical work activity behavioural patterns during a 12‐hr shift

“…A range of studies have used objective measurements to describe nurse physical activity during work hours (Hajo et al., 2020; Reed, Prince, et al, 2018; Schall, Fethke, & Chen, 2016), in leisure time (Loef et al., 2018; Reed, Cole, et al, 2018), and specifically in ICU clinical settings (Kwiecień‐Jaguś, Mędrzycka‐Dąbrowska, Czyż‐Szypenbeil, Lewandowska, & Ozga, 2019). The measurements for identifying ICU nurse physical work activity have included time‐motion analysis utilising an e‐ICU technology (Tang, Mazabob, Weavind, Thomas, & Johnson, 2006), a video‐based method (Fiedler, Weir, van Wyk, & Andrews, 2012), time‐tracking software (called Togg; de Campos, de Oliveira, & Perroca, 2018), and pedometers (Kwiecień‐Jaguś et al., 2019).…”

“…Cumulatively, this body of research has shown that ICU nurses spent the majority of their time in standing and walking behaviours while performing nursing tasks (de Campos et al., 2018; Fiedler et al., 2012; Tang et al., 2006). However, the study by Kwiecień‐Jaguś et al.…”

Nursing workload: influence of indirect care interventions

“…The interventions considered more representative differ from other studies and showed greater time-consuming values in: documentation (13)(14)(15)(16)(17) ; supervision (14)(15)(16) ; shift change (13)(14)(15)17) ; health care information exchange (13,(16)(17) ; and delegation (13)(14)(15) .…”