A new way to measure nursing: computer timing of nursing time and support of laboring patients

The goal of this observational, descriptive study was to use an innovative computerized program to measure simultaneous nursing time and support activities during the first stage of active labor. No previous studies have looked at nursing time or support from the view of those in the labor room or have measured multitasking in labor care. A computerized timing program (developed using Microsoft Visual C++ version 6.0) was developed to accommodate time recording of up to seven simultaneous activities for nursing events during labor care. The program was highly usable and effective. It was determined that labor nurses spent an average of 69% of their time out of the patient's rooms and 31% of their time in the room of the active laboring patient. On average, patients received nursing supportive care for 13% of their active phase of labor. While in the room, 41% of the nurses' time was spent in supportive care and 63% was spent in other nursing activities. On average, nurses engage in only one observable activity 70% of the time; two activities, 20% of the time; and three activities, 1.5% of the time. This finding falls short of recommendations for provision of labor support.