Mapping nurses' activities in surgical hospital wards: A time study

Area of Science:

• Nursing
• Healthcare Management
• Workforce Optimization

Background:

• Effective nurse staffing balances patient needs with hospital resources.
• Workload management methods often rely on time studies to assess nurse activities and patient factors.
• Optimizing nurse time is key to efficient healthcare delivery and resource utilization.

Purpose of the Study:

• To quantify how nurses allocate their time during a typical workday.
• To identify and explain variations in nurse activities across different specialized surgical wards.
• To contribute to improved nurse workload management strategies.

Main Methods:

• A work sampling methodology was employed in six surgical wards of an academic hospital.
• Trained observers recorded nurse activities and patient details every ten minutes over three weeks during day shifts.
• Data collected included direct patient care, collective patient care, and time spent at the patient's bedside.

Main Results:

• Nurses spent 52.1%–68% of their time on direct and indirect patient care.
• Significant differences in activities were observed across wards (10 of 21 groups).
• Time spent at the patient's bedside averaged 31%, lower in teaching departments (25%) compared to regular surgical wards (34%).

Conclusions:

• A lower-than-expected percentage of time was dedicated to direct/indirect patient care and bedside activities, potentially due to academic hospital educational tasks.
• Ward-specific differences in nurse activities were influenced by patient mix, staffing, and surgical type, though not all variations were explained.
• Further research is needed to fully understand and explain the variations in nurses' activities across different hospital settings.