Understanding the work of intensive care nurses: a time and motion study

The work activities of an Intensive Care Unit (ICU) nurse is frequently dynamic and variable. The activities are not necessarily linear actions that occur in a structured manner but are more complex and not well documented. A greater understanding of the type and level of activity assists in informing workload models.

The aim of this study was to describe and analyse the work activities of bedside Intensive Care Unit (ICU) nurses during the day shift.

Time and motion observational methodology was used to observe 10 bedside ICU nurses during the day shift, Monday to Friday. All activities undertaken by the nurses during their shift were timed and recorded and then were coded according to whether they involved direct or indirect patient activities, or were unit or personally related.

Just over 76h of observations occurred over 10 days and 3081 activities documented during this time. The major work activity groups for the ICU nurses were; 'direct care' 1857 activities and 40.5% of their time, 'indirect care' 986 activities and 32.4% of their time, 'personal' activities 140 activities and 21.9% of their time and 'unit-related' 98 activities and 5.0% of their time. The ICU nurses undertook two activities simultaneously for 43% of the study timeframe.

This study provides baseline evidence on the activities nurses undertake on a daily basis, with only about a quarter of their time not being spent on patient care activities, either directly or indirectly.