Structure of the Working Time of Nurses in Emergency Departments in Polish Hospitals

Authors: Jadwiga Klukow, Anna Ksykiewicz-Dorota

Abstract:

An analysis of the distribution of nurses’ working time constitutes vital information for the management in planning employment. The objective of the study was to analyze the distribution of nurses’ working time in an emergency department. The study was conducted in an emergency department of a teaching hospital in Lublin, in Southeast Poland. The catalogue of activities performed by nurses was compiled by means of continuous observation. Identified activities were classified into four groups: Direct care, indirect care, coordination of work in the department and personal activities. Distribution of nurses’ working time was determined by work sampling observation (Tippett) at random intervals. The research project was approved by the Research Ethics Committee by the Medical University of Lublin (Protocol 0254/113/2010). On average, nurses spent 31% of their working time on direct care, 47% on indirect care, 12% on coordinating work in the department and 10% on personal activities. The most frequently performed direct care tasks were diagnostic activities – 29.23% and treatment-related activities – 27.69%. The study has provided information on the complexity of performed activities and utilization of nurses’ working time. Enhancing the effectiveness of nursing actions requires working out a strategy for improved management of the time nurses spent at work. Increasing the involvement of auxiliary staff and optimizing communication processes within the team may lead to reduction of the time devoted to indirect care for the benefit of direct care.

Keywords: Emergency nurses, nursing care, workload, work sampling.

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1124177

References:

[1] J.M. Pines, J.F Hollander “Emergency department crowding is associated with poor care for patients with severe pain”. Ann Emerg Med, vol. 51, pp. 1-5, 2008.
[2] D.B. Richardson “Increase in patient mortality at 10 days associated with emergency department overcrowding. Med J, vol.184, n. 5, pp. 213-216, 2006.
[3] J.I Westbrook, C.Li.L. Duffield, N.J. Creswick” How much time do nurses have for patients? a longitudinal study quantifying hospital nurses’ patterns of task time distribution and interactions with health professionals”. BMC Health Serv Res, vol.11, pp. 319, 2011.
[4] W. Sermeus, L.H. Aiken, K. Van den Heede, A.M. Rafferty, P. Griffiths, M.T. Moreno-Casbas, R. Busse, R. Lindqvist., A.P. Scott, L. Bruyneel, T. Brzostek., J. Kinnunen, M. Schubert, L. Schoonhoven, D. Zikos “Nurse forecasting in Europe (RN4CAST): rationale, design, and methodology. BMC Nursing, vol. 10, n. 6, http://www.biomedcentral. com/1472-6955/10/6, 2011.
[5] L.H. Aiken, W. Sermeus, K. Van den Heede, D.M. Sloane, R. Busse, M. Martin McKee, L. Bruyneel, A.M. Rafferty, P. Griffiths, M.T. Moreno-Casbas, C. Tishelman, A. Scott, T. Brzostek, J. Kinnunen, R. Schwendimann, M. Heinen, D. Zikos, I. Strømseng Sjetne, H.L. Smith, A. Kutney-Lee “Patient safety, satisfaction, and quality of hospital care: cross-sectional surveys of nurses and patients in 12 countries in Europe and the United States”. Br Med J, vol. 344, e1717, http://dx.doi.org/10.1136/bmj.e1717, 2012.
[6] L.H. Aiken, D.M. Sloane, S. Clarke, L. Poghosyan, E. Cho, L. You, M. Finlayson, M. Kanai-Pak, Y Aungsuroch, “Importance of work environments on hospital outcomes in 9 countries”. In J Qual Health Care, vol. 23, n. 4, pp. 357–364, 2011.
[7] J.C. Hollingsworth, C.D. Chisholm., B.K Giles W.H Cordell, D.R Nelson “How do physicians and nurses spend their time in the emergency department?” Ann Emerg Med, vol. 31, n. 1 pp. 87–91, 1998.
[8] E.A. Garcia., R.M. Fugulin “Nurses’ work time distribution at the emergency service”. Rev Esc Enferm USP, vol. 44, n. 4, pp. 1027–1033, 2010.
[9] M. Gholizadeh, A. Janati, N. Kabiri, B. Nadimi, A. Samayeh “How Do Nurses Spend Their Time in the Hospital?” J Clin Res Gov, vol. 2, pp. 27-33, 2014.
[10] C. Hobgood, J. Villani, R. Quattlebaum “Impact of emergency department volume on registered nurse time at the bedside”. Ann Emerg Med, vol. 46 n.6, pp. 481–489, 2010.
[11] K. Yen., E. L. Shane, SS. Pawar., ND Schwendel., RJ. Zimmanck, MH. Gorelick “Time motion study in a Pediatric Emergency Department before and after computer physician order entry”. Ann Emerg Med, vol. 3, n. 4, pp. 462–468, 2008.
[12] M. Hertzum, J. Simonsen “Work-Practice Changes Associated with an Electronic Emergency-Department Whiteboard”. Health Informatics J, vol. 19, n. 1, pp. 46-60, 2013.
[13] D. Aronsky, I. Jones, K. Lanaghan, CM. Slovis “Supporting patient care in the emergency department with a computerized whiteboard system”. J Am Med Inform Assoc, vol. 15, pp. 184-94, 2008.