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Observing how RNs use clinical time in a nursing home: a pilot study
Mary Ellen Dellefield1, Charlene Harrington, Ann Kelly
1VA San Diego Healthcare System, San Diego, CA, USA.
Geriatric Nursing (New York, N.Y.)
|February 21, 2012
Summary
Registered nurses (RNs) in nursing homes (NHs) spend most of their time on indirect care tasks. This study highlights the need for RNs to strategically allocate their clinical time for better patient outcomes.
Area of Science:
- Gerontology
- Nursing Home Care
- Healthcare Management
Background:
- Registered nurses (RNs) are essential but scarce professionals in nursing homes (NHs).
- RN responsibilities encompass direct patient care and indirect care activities crucial for managing the care environment.
- Understanding the time allocation between direct and indirect care is vital for optimizing nursing home operations.
Purpose of the Study:
- To quantify the distribution of direct versus indirect care activities performed by RNs during day shifts in a nursing home setting.
- To examine the extent to which RN direct care activities relate to specific clinical outcomes, such as pressure ulcer prevention.
Main Methods:
- Utilized a work sampling methodology to observe and record all RN care activities.
- Employed a personal data assistant-based RN Observation Measure for data collection.
- Focused observations on RNs working the day shift within a nursing home.
Main Results:
- Registered nurses dedicated 59% of their work time to indirect care activities.
- A limited amount of direct care time was specifically associated with pressure ulcer prevention efforts.
- The study observed a significant portion of RN time allocated to non-resident-facing tasks.
Conclusions:
- RNs in nursing homes face challenges in effectively managing their time between direct and indirect care.
- There is a need for strategies to help RNs utilize their clinical time more strategically to improve patient care and outcomes.
- Optimizing RN time allocation may enhance the focus on critical clinical areas like pressure ulcer prevention.
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