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Association between the PERROCA patient classification system and nursing workload: A multicentre cross-sectional
Arian Zaboli1, Pasquale Solazzo2, Manuel Rigger3
1Health Professions Management, South Tyrolean Health Authority (SABES-ASDAA), Bolzano, Italy.
Applied Nursing Research : ANR
|August 3, 2026
Summary
The PERROCA Patient Classification System accurately reflects nursing workload, showing a significant association with nursing care time across diverse hospital settings. This tool aids in effective staffing and patient allocation.
Area of Science:
- Healthcare Management
- Nursing Informatics
- Clinical Operations
Background:
- Accurate nursing workload measurement is crucial for hospital staffing and patient allocation.
- Limited evidence exists on the PERROCA Patient Classification System's effectiveness in diverse hospital environments.
- Assessing workload is vital for optimizing resource allocation and ensuring quality patient care.
Purpose of the Study:
- To evaluate the association between the PERROCA Patient Classification System and actual nursing workload.
- To determine if PERROCA scores independently predict nursing care time across various hospital wards.
- To validate PERROCA as a tool for measuring nursing workload in real-time.
Main Methods:
- Prospective, multicentre, cross-sectional study involving 12 wards in five hospitals.
- Nursing workload measured as total real-time recorded nursing care time over 24 hours.
- Statistical analysis included linear regression and mixed-effects models to assess associations.
Main Results:
- 472 adult inpatients were included; median PERROCA score was 17, median nursing care time was 155 minutes.
- Each 1-point PERROCA increase correlated with 7.45 additional minutes of nursing care time (mixed model).
- PERROCA was independently associated with high nursing workload in 23.7% of patients.
Conclusions:
- The PERROCA Patient Classification System demonstrates a significant association with measured nursing workload.
- PERROCA shows potential as a practical tool for estimating nursing workload in varied hospital settings.
- Findings support PERROCA's utility in staffing decisions and patient care management.
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