How do nurses use their time?
ABSTRACT Nurses spend an average of only 31% of their time with patients. The authors determined how nurses spend their time and suggest three ways to reduce time spent on non-essential nursing functions: delegation of some tasks to support personnel, greater use of pharmacy personnel in a decentralized setting, and greater use of computers. Together these changes may both decrease demand for nurses' time and enable professional nurses to focus their energy on tasks that require professional expertise.
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ABSTRACT: BACKGROUND:: Researchers have used various methods to describe and quantify the work of nurses. Many of these studies were focused on nursing in general care settings; therefore, less is known about the unique work nurses perform in intensive care units (ICUs). OBJECTIVES:: The aim of this study was to observe adult and pediatric ICU nurses in order to quantify and compare the duration and frequency of nursing tasks across four ICUs as well as within two discrete workflows: nurse handoffs at shift change and patient interdisciplinary rounds. METHODS:: A behavioral task analysis of adult and pediatric nurses was used to allow unobtrusive, real-time observation. A total of 147 hours of observation were conducted in an adult medical-surgical, a cardiac, a pediatric, and a neonatal ICU at one rural, tertiary care community teaching hospital. RESULTS:: Over 75% of ICU nurses' time was spent on patient care activities. Approximately 50% of this time was spent on direct patient care, over 20% on care coordination, 28% on nonpatient care, and approximately 2% on indirect patient care activities. Variations were observed between units; for example, nurses in the two adult units spent more time using monitors and devices. A high rate and variety of tasks were also observed: Nurses performed about 125 activities per hour, averaging a switch between tasks every 29 seconds. DISCUSSION:: This study provides useful information about how nurses spend their time in various ICUs. The methodology can be used in future research to examine changes in work related to, for example, implementation of health information technology.Nursing research 01/2013; 62(1):50-58. · 1.80 Impact Factor
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ABSTRACT: The work activities of an Intensive Care Unit (ICU) nurse is frequently dynamic and variable. The activities are not necessarily linear actions that occur in a structured manner but are more complex and not well documented. A greater understanding of the type and level of activity assists in informing workload models. The aim of this study was to describe and analyse the work activities of bedside Intensive Care Unit (ICU) nurses during the day shift. Time and motion observational methodology was used to observe 10 bedside ICU nurses during the day shift, Monday to Friday. All activities undertaken by the nurses during their shift were timed and recorded and then were coded according to whether they involved direct or indirect patient activities, or were unit or personally related. Just over 76h of observations occurred over 10 days and 3081 activities documented during this time. The major work activity groups for the ICU nurses were; 'direct care' 1857 activities and 40.5% of their time, 'indirect care' 986 activities and 32.4% of their time, 'personal' activities 140 activities and 21.9% of their time and 'unit-related' 98 activities and 5.0% of their time. The ICU nurses undertook two activities simultaneously for 43% of the study timeframe. This study provides baseline evidence on the activities nurses undertake on a daily basis, with only about a quarter of their time not being spent on patient care activities, either directly or indirectly.Australian Critical Care 09/2011; 25(1):13-22. · 0.95 Impact Factor
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ABSTRACT: Variations in service delivery have been identified as a major challenge to the success of process improvement studies in service departments of hospital such as radiology. Largely, these variations are due to inherent system level factors, i.e., system variations such as unavailability of resources (nurse, bed, doctors, and equipment). These system variations are largely unnecessary/unwarranted and mostly lead to longer waiting times, delays, and lowered productivity of the service units. There is limited research on identifying sys-tem variations and modelling them for service improvements within hospital. Therefore, this paper proposes a modelling methodology to model system variations in radiology based on real time locating system (RTLS) tracking data. The methodology employs con-cepts from graph theory to identify and represent system variations. In particular, edge col-oured directed multi-graphs (ECDMs) are used to model system variations which are reflected in paths adopted by staff, i.e., sequence of rooms/areas traversed while delivering services. The main steps of the methodology are: (i) identifying the most standard path fol-lowed by staff for service delivery; (ii) filtering the redundant events in RTLS tracking data-base for analysis; (iii) identifying rooms/areas of hospital site involved in the service delivery; (iv) determining patterns of paths adopted by staff from filtered tracking data-base; and, (v) representation of patterns in graph based model called as edge coloured directed multigraphs (ECDMs) of a role. A case study of MR scanning process is utilized to illustrate the implementation of the proposed methodology for modelling system vari-ations reflected in the paths adopted by staff.Applied Mathematical Modelling 01/2013; · 1.71 Impact Factor