Estimating the Relationship Between Nurse Staffing and Medication Pass Workload Using National Barcode Data.

Area of Science:

• Nursing
• Healthcare Management
• Health Services Research

Background:

• Assessing inpatient nurse staffing and workload is challenging due to difficulties in systematically observing unit-level workload.
• Existing methods for measuring nurse workload lack granularity at the unit level within large health systems.

Purpose of the Study:

• To apply a novel measure of inpatient nurse workload to estimate the relationship between nurse staffing and workload.
• To analyze nurse workload during the peak-time medication pass as a key nursing activity.

Main Methods:

• A retrospective observational study was conducted in the Veterans Health Administration.
• Data included 1,578,399 patient days across 311 non-ICU acute care units in 112 hospitals (2019).
• Nurse staffing was measured as the unit-level nurse-to-patient ratio; workload was the average time for RNs to complete the peak-time medication pass.

Main Results:

• A nonlinear negative relationship was found between the RN-to-patient ratio and average peak-time medication pass duration.
• Increased nurse staffing was associated with decreased average RN workload.
• The marginal effect of staffing on workload decreased as staffing levels increased.

Conclusions:

• Higher unit-level nurse staffing is associated with reduced average RN workload during medication passes.
• Interventions to improve nurse staffing may yield greater benefits in units with lower staffing levels.
• Peak-time medication pass duration is a valid process-based workload measure, indicating potential diminishing returns from increased staffing.