Time Allocated to Nursing Tasks on Hospital Units Caring for Older Patients

Hospitals need objective data about the time allocated to nursing tasks, particularly for older inpatients who often need assistance with activities of daily living (ADLs), such as toileting and mobility.

This descriptive time-motion study objectively measured the time registered nurses (RNs) and nursing assistants (NAs) spent on clinical and ADL care and made comparisons by staff type. Research staff completed 277 standardized observation hours on three hospital units caring for older patients.

Registered nurses and NAs spent 38% and 34% of their time, respectively, on indirect care tasks, with medical record documentation being most common. Both staff types spent an additional 34% of their time on direct care tasks. Medication pass consumed the most RN direct care time, and ADL care consumed the most NA direct care time. Activities of daily living care was observed in fewer than 25% of patient encounters, despite 73%-89% of patients across the three units requiring ADL care assistance. Overall, staff spent less than 10% of their time idle.

Objective data related to the time allocated to nursing tasks are necessary to inform skill mix adjustments or other staffing strategies to meet older inpatients' care needs.