Using clinical data to capture nurse workload: implications for staffing and safety.

Area of Science:

• Nursing Informatics
• Healthcare Management
• Patient Safety Research

Background:

• Nurse staffing levels are linked to patient safety outcomes.
• Existing workload measures, like the midnight census, are insufficient.
• Accurate nurse workload measurement is crucial for patient safety.

Purpose of the Study:

• To demonstrate hospital clinical databases for calculating nursing unit activities.
• To assess nurse workload and its impact on patient safety.
• To introduce a unit activity index as a novel workload measure.

Main Methods:

• Utilized a hospital clinical data repository.
• Calculated workload measures: total treated patients, midnight census, admissions, discharges, and transfers (ADT).
• Developed and compared unit activity indexes for intensive care and medical-surgical units over time, by shift, day, and month.

Main Results:

• Unit activity indexes increased from 1994 to 2006.
• Admissions, discharges, and transfers (ADT) varied significantly by unit type.
• Unit activity index showed fluctuations based on shift, day of week, and month.

Conclusions:

• Hospital clinical data repositories are effective for calculating workload measures.
• Unit activity indexes provide a more comprehensive view of nurse workload than traditional methods.
• Incorporating these workload measures into staffing decisions is recommended for improved patient safety.