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A Current State Assessment on Nursing Work Activities: An Observational Study
Zachary Perpetua1, Jennifer Lennon, Judith A Shovel
1Health Services Division (Ms Minnier), Center for Quality Improvement and Innovation, Wolff Center (Mss Lennon, Shovel, Appell, Patterson, and Martin and Drs Zapf and Kip); ICU Service Center (Dr Sackrowitz); Department of Critical Care Medicine (Dr Sackrowitz); and Department of Nursing (Ms McLaughlin), University of Pittsburgh Medical Center; Department of Acute and Tertiary Care (Dr Perpetua), University of Pittsburgh, Pittsburgh, Pennsylvania.
Background:
Nationwide nursing shortages have led to higher patient-to-nurse ratios, nursing burnout, and decreased quality of care.
Local Problem:
Staffing challenges and nursing burnout were becoming growing concerns and success was contingent upon efficient use of existing resources.
Methods:
Direct observation current state assessment was completed on medical-surgical specialty units to better understand work activities of registered nurses (RNs) and unlicensed assistive personnel (UAPs).
Results:
RNs spent more time performing indirect care (eg, documentation) than direct patient care. Interruptions and problems consumed 17.4% and 5.6% of their time, respectively. UAPs performed more direct patient care but had a higher proportion of downtime. RNs underdelegated nonclinical tasks.
Conclusions:
Direct observation current state assessment offers a better understanding of workflow and workload inefficiencies. This information is critical to provide informed, evidence-based recommendations to develop future patient care models with more capacity to deliver high-quality care with greater efficiency and lessen nursing burden and burnout during the nursing shortage crisis.
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