Student Dissertation

Agency : Nursing Activity Analysis; Critical Services; Non Critical Services; Nursing Care

Objective : A time and motion study was done to document how nurses spend their time. The goal was To identify the daily nursing workload Time given to nursing activities in critical and noncritical areas Finding out the time distribution over non nursing activities

Background : Nurses are the primary hospital caregivers. Increasing the efficiency and effectiveness of nursing care is essential to hospital function and the delivery of safe patient care.

Methodology : • A work sampling observational study • Non participatory Observational technique was used to collect the data and the analysis was done using Tool s like excel and advanced excel. • Proper Introduction was given to the nursing staff working in the ward during handover shift meeting and explained about the purpose of the study. • This enabled me to familiarize with the nursing staff and enabled nursing persons to become comfortable with the observer which could potentially reduce the “Hawthorne effect” and lead to an accurate recording of nursing activities.

Findings : A total of 30 staff nurses were followed and their activities were clocked for a complete duration of 240 hours in critical (icu, nicu/picu, sicu, ccu) and non critical areas (general ward, twin sharing, single rooms and deluxe rooms) of the hospital. Equally divided in the two categories the study was completed. What came out as the result was that 10+ hrs i.e. 41 % of the nurses time in a day goes out in doing the non nursing activities in the non critical area and about 6 hrs i.e. 25% of the times the nurses had to do the non nursing activities in the critical area in a day. This Gave less amount of time in the non critical areas to patient care, affecting the delivery of health care in the hospital.

Recommendations : The time and motion study identified the main targets for improving the efficiency of nursing care: Indenting/ receiving medicine, documentation on the hospital information system, arranging beds and supplies and searching or arranging for the housekeeping for patient requirements. Allocating floating clinical pharmacists, and ward secretaries to look after all the non nursing activities along with Changes in technology, work processes, may allow for substantial improvements in the use of nurses’ time and the Safe delivery of care.

30 staff nurses were shadowed for 240 hours in research protocols designed to assess how nurses spend their time, differentiating the activities into nursing and non nursing activities. Main Outcome Measures: Nurses’ time was divided into categories of activities involved in patient care, in direct patient care, waste. Types of wastes, identified: • Indenting/receiving medicine • HIS Indenting store • Phone calls • Call bells • Arranging bed/ supplies • arranging instructing hsk • updating file on HIS • File work • sorting reports • register • talking • resting • washroom • tea break • shift transitions