Reorganizing nursing work on surgical units: a time-and-motion study

Area of Science:

• Nursing Science
• Healthcare Management
• Workforce Productivity

Background:

• Perceptions of excessive non-nursing care by surgical nursing staff prompted the study.
• Optimizing nursing time is crucial for efficient healthcare delivery and patient outcomes.

Purpose of the Study:

• To quantify the time spent by surgical nursing staff on various activities.
• To identify areas for potential workflow improvements and task reallocation.

Main Methods:

• A time-and-motion study observed 30 nurse shifts, totaling 201 working hours.
• Trained observers used Personal Digital Assistants to record activities.
• Activities were categorized into direct patient care, indirect patient care, non-nursing, and personal tasks.

Main Results:

• Nurses spent 32.8% on direct care, 55.7% on indirect care, 9.0% on non-nursing tasks, and 2.5% on personal activities.
• Indirect care time was dominated by communication, medication verification/preparation, and documentation (78.9%).
• Increased indirect care time was linked to night shifts and short-stay surgical units.

Conclusions:

• Time-and-motion studies are effective for monitoring nursing staff activities.
• Findings can guide restructuring of nursing tasks to enhance efficiency.
• Focusing on reducing time spent on communication and medication tasks can improve workflow.