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Measuring nursing workload in neonatal intensive care.

Kaye Spence1, William Tarnow-Mordi, Glen Duncan

  • 1The Children's Hospital at Westmead, Sydney, Australia, The University of Melbourne, Australia. kaye@chw.edu.au

Journal of Nursing Management
|April 8, 2006
PubMed
Summary

Developing effective nursing workload measurement in neonatal intensive care units (NICUs) requires considering nurse skill and organizational factors, not just patient acuity. This approach better captures the intensity of care provided.

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Area of Science:

  • Neonatal Intensive Care Unit (NICU) Nursing
  • Healthcare Management
  • Nursing Workload Assessment

Background:

  • Traditional nursing workload measures in NICUs often overlook individual nurse capabilities and focus on metrics like bed occupancy or ventilator use.
  • Existing classification systems may not adequately account for the clinical skill level of individual nurses, impacting workload accuracy.

Purpose of the Study:

  • To develop and evaluate a suitable method for measuring nursing workload in neonatal intensive care units (NICUs).
  • To identify factors contributing to nursing workload beyond traditional patient acuity measures.

Main Methods:

  • A 5-month prospective study involving nurses in two NICUs.
  • Nurses assessed patient dependency and the intensity of care required per shift.

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  • Severity of illness scores were collected serially for each patient.

    • Main Results:

    • Traditional dependency measures for estimating nursing hours did not align with current practice or account for nurse skill.
    • A method where nurses indicated the intensity of care needed for patients effectively captured individual capabilities.
    • Organizational factors were identified as significant contributors to nursing workload.

    Conclusions:

    • Patient acuity or severity of illness alone is insufficient for accurate nursing workload estimation.
    • Incorporating nurses' assessment of care intensity and organizational factors is crucial for comprehensive workload evaluation.