Implications for Virtual Nursing Role Development in Acute Nursing Care: 24-Hour Time-and-Motion Study.

Area of Science:

• Nursing Workforce Management
• Healthcare Operations Research
• Clinical Workflow Analysis

Background:

• Understanding current nursing workflows is crucial for redesigning healthcare staffing, including virtual nursing positions.
• There is a lack of detailed data on nursing time allocation and multitasking across different staff levels over a 24-hour period.

Purpose of the Study:

• To quantify time spent on direct and indirect care by registered and enrolled nurses in acute medicine.
• To identify multitasking patterns and temporal distributions in nursing workflows.
• To explore potential for virtual nursing roles to optimize care delivery.

Main Methods:

• Employed time-and-motion methodology to observe nurses in general acute medicine wards.
• Tracked task categories including administrative, communication, and bedside care over 24-hour periods.
• Monitored multitasking occurrences (simultaneous task performance) during observed shifts.

Main Results:

• Registered nurses dedicated 70% of daytime hours to indirect care, versus 54% for enrolled nurses.
• Indirect care time decreased at night for both nurse types, but remained substantial.
• Registered nurses multitasked an average of 209 minutes daily; enrolled nurses multitasked 152 minutes daily.

Conclusions:

• Significant portions of nursing time are spent on indirect care and multitasking, indicating workflow inefficiencies.
• Virtual nursing roles present an opportunity to offload specific tasks, potentially reducing nurse burden.
• Thoughtful implementation of virtual nursing could enhance efficiency and care quality in acute settings.