Tracking Day Shift Nurses' Work Patterns Using an Indoor Positioning System in an Internal Medicine Ward at a...

Area of Science:

• Nursing workload analysis
• Healthcare technology assessment
• Hospital management systems

Background:

• Japan's Diagnosis Procedure Combination/Per-Diem Payment System (DPC/PDPS) mandates efficient healthcare delivery.
• Shortened hospital stays increase the need for objective nursing workload evaluation.
• Traditional time-motion studies are resource-intensive, necessitating scalable alternatives like Indoor Positioning Systems (IPS).

Purpose of the Study:

• To quantify day-shift nurses' location-based time-use via IPS.
• To assess the impact of staffing levels and weekday/weekend status on bedside care and room presence within a DPC/PDPS ward.

Main Methods:

• Prospective time-motion study in a 51-bed internal medicine ward.
• 153 day shift records analyzed using smartphones and Bluetooth Low Energy (BLE) beacons.
• Statistical analysis included Mann-Whitney U tests and Spearman's ρ.

Main Results:

• Nurses spent most time at the nurses' station (36%) and patient rooms (30%).
• Total patient-room time was significantly higher on weekends (214.5 min) vs. weekdays (160.8 min).
• Higher nurse staffing correlated with reduced per-nurse room time (Spearman's ρ = -0.94, p = 7.2 × 10⁻⁷).
• Bedside time per patient was longer on weekdays (43.16 min) vs. weekends (28.14 min).

Conclusions:

• IPS effectively quantified nurse location and workload patterns.
• Increased weekday staffing correlated with more focused bedside care.
• IPS offers a scalable, data-driven tool for evaluating nursing efficiency and informing staffing policies under DPC/PDPS.