How nursing staff spend their time on activities in a nursing home: an observational study.

AIM This article is a report of a study to examine how nursing staff spend their time on activities in a nursing home. BACKGROUND Few studies have investigated how nursing staff spend their time on activities in a nursing home. Such information is important for nurse managers in deciding on staff deployment, and for evaluating the effects of changes in nursing practice. METHOD A work sampling study with an observational component was undertaken in 2009 with nursing staff at a nursing home. RESULTS A total of 430 activities were recorded for Registered Nurses, 331 for Endorsed Enrolled Nurses, 5276 for Personal Carers, and 501 for Recreational Activity Officers. Registered Nurses spent 48·4% of their time on communication and 18·1% on medication management. Endorsed Enrolled Nurses spent 37·7% on communication and 29·0% on documentation tasks. Communication was the most time-consuming activity for Recreational Activity Officers and Personal Carers, except that Personal Carers in a high care house spent more time on direct care duties. Hygiene duties and resident interaction were more frequently multitasked by the nursing staff in high care than in low care house. CONCLUSION Nursing staff value their face-to-face interaction for successful care delivery. There is need, however, to investigate the effects of this form of communication on quality of care given to residents. Differences in multi-tasked activities between high care and low care houses should be considered when deploying staff in a nursing home.

[1]  Christine Duffield,et al.  Documentation and the transfer of clinical information in two aged care settings. , 2005, The Australian journal of advanced nursing : a quarterly publication of the Royal Australian Nursing Federation.

[2]  Ruth Harris,et al.  Work sampling: a quantitative analysis of nursing activity in a neuro-rehabilitation setting. , 2009, Journal of advanced nursing.

[3]  Emmy Rood,et al.  Intensive care information system reduces documentation time of the nurses after cardiothoracic surgery , 2002, Intensive Care Medicine.

[4]  S A Finkler,et al.  A comparison of work-sampling and time-and-motion techniques for studies in health services research. , 1993, Health services research.

[5]  F. Abdellah,et al.  Work‐Sampling Applied to the Study of Nursing Personnel , 1954, Nursing research.

[6]  Brian Hakes,et al.  Assessing the Impact of an Electronic Medical Record on Nurse Documentation Time , 2008, Computers, informatics, nursing : CIN.

[7]  Joann L. Baril,et al.  Nursing Time Devoted to Medication Administration in Long‐Term Care: Clinical, Safety, and Resource Implications , 2009, Journal of the American Geriatrics Society.

[8]  D. Pelletier,et al.  Work sampling: valuable methodology to define nursing practice patterns. , 2003, Nursing & health sciences.

[9]  Marianne Wallis,et al.  A comparison of activities undertaken by enrolled and registered nurses on medical wards in Australia: an observational study. , 2008, International journal of nursing studies.

[10]  Dean F. Sittig,et al.  Work-Sampling: A Statistical Approach to Evaluation of the Effect of Computers on Work Patterns in Healthcare , 1993, Methods of Information in Medicine.

[11]  L D Urden,et al.  Work Sampling: A Decision-Making Tool for Determining Resources and Work Redesign , 1997 .

[12]  R. Tappen,et al.  Nursing staff time allocation in long-term care: a work sampling study. , 1997, The Journal of nursing administration.

[13]  Johanna I. Westbrook,et al.  Design, application and testing of the Work Observation Method by Activity Timing (WOMBAT) to measure clinicians' patterns of work and communication , 2009, Int. J. Medical Informatics.

[14]  Jill Manthorpe,et al.  An International Review of the Long-Term Care Workforce , 2005, Journal of aging & social policy.

[15]  E. Buikstra,et al.  Workforce issues in nursing in Queensland: 2001 and 2004. , 2006, Journal of clinical nursing.

[16]  M. Koopmanschap,et al.  The Role of Disability in Explaining Long-Term Care Utilization , 2009, Medical care.

[17]  Carolyn E Aydin,et al.  Nursing Documentation Time During Implementation of an Electronic Medical Record , 2003, The Journal of nursing administration.

[18]  A. Vogelsmeier,et al.  Barriers to safe medication administration in the nursing home--exploring staff perceptions and concerns about the medication use process. , 2007, Journal of gerontological nursing.

[19]  C. McLaughlin,et al.  Finding time for patients: an exploration of nurses' time allocation in an acute psychiatric setting. , 2000, Journal of psychiatric and mental health nursing.

[20]  Christine Duffield,et al.  Tell me what we do. Using work sampling to find the answer. , 2003 .

[21]  Debra Jackson,et al.  NURSING STAFF SHORTAGES: ISSUES IN AUSTRALIAN RESIDENTIAL AGED CARE , 2003 .

[22]  Stanley Lemeshow,et al.  Sample Size Determination in Health Studies: A Practical Manual , 1991 .

[23]  R. Hansen,et al.  Preventing medication errors in long-term care: results and evaluation of a large scale web-based error reporting system , 2007, Quality and Safety in Health Care.

[24]  C. Duffield,et al.  Nursing skill mix and nursing time: the roles of registered nurses and clinical nurse specialists. , 2005, The Australian journal of advanced nursing : a quarterly publication of the Royal Australian Nursing Federation.