An analysis of nursing activity in a day care and inpatient dermatology service

The nursing context within which dermatological treatments are provided has received limited investigation. This activity analysis survey examined how nursing time is organized (n=17 nurses) within in- and out-patient day care services in a hospital teaching dermatology department, using a newly developed standardized tool over a 24-week period. The setting was a day care and inpatient facility in a UK dermatology department. Patients (n=108) referred to these services for day care or inpatient care over 24 weeks, excluding emergencies, were recruited consecutively; 76% (n=82) were seen during this time. Most patients (>95%) were referred for clearance of an acute episode of a chronic skin condition and specifically education. The total mean time in contact with the nursing service (mean hours/case) was 43.1 for inpatient and 6.6 for day care. Time in day care was mainly spent (mean hours/case) on direct care (living activities and dermatological treatments) (4.3), followed by teaching (2) and support (1.6). The pattern of inpatient care was similar. A profile has been derived that is indicative of how dermatology nurses spend their time in day and inpatient care. There may be scope for day care nursing to make more effective use of education opportunities to support patient self-management.