A Current State Assessment on Nursing Work Activities: An Observational Study.

Area of Science:

• Healthcare Management
• Nursing Workflow Analysis
• Clinical Operations

Background:

• Nationwide nursing shortages exacerbate patient-to-nurse ratios and contribute to burnout.
• Decreased quality of care is a significant consequence of current staffing challenges.

Purpose of the Study:

• To assess current workflow and workload inefficiencies among registered nurses (RNs) and unlicensed assistive personnel (UAPs).
• To identify opportunities for optimizing resource utilization in response to staffing challenges and nursing burnout.

Main Methods:

• Direct observation current state assessment conducted on medical-surgical units.
• Analysis of work activities performed by RNs and UAPs.

Main Results:

• RNs dedicated more time to indirect care activities, such as documentation, compared to direct patient care.
• Interruptions and problem-solving accounted for a substantial portion of RNs' work time (17.4% and 5.6%, respectively).
• UAPs performed more direct patient care but experienced higher downtime; RNs underdelegated nonclinical tasks.

Conclusions:

• Direct observation provides critical insights into workflow and workload inefficiencies.
• Evidence-based recommendations can be developed to enhance patient care models for greater efficiency.
• Addressing these inefficiencies is vital to lessen nursing burden and burnout during critical staffing shortages.