The qualitative dimension of Nursing workload: a measurement proposal

Abstract

Objective:construct and test a proposal to measure the qualitative dimension of nursing workload; identify the workload cut-off point and its indicator as predictors of the good and optimal nursing care product score.Method:this is a descriptive study conducted in four inpatient units and four intensive care units of a Brazilian teaching hospital, considering 308 evaluations performed by 19 nurses. Four measurement instruments were used: three to assess the care demand in relation to nursing and the other to classify the care product delivered at the end of the shift. The workload was calculated and its indicator was constructed.Results:a weak and inverse correlation was found between the care product score, workload and the workload indicator and the workload indicator in the units and moderate and inverse between Nursing care planning and Care needs assistance with the number of hospitalized patients.Conclusion:it is possible to associate workload and its indicator with the care product. Nursing workload ≤ 173 hours (24 hours) and indicator ≤ 12.3 hours / professional were associated with a higher probability of obtaining a “good” and “optimal” score in the care product in the inpatient units.

Multicenter application of a nursing workload measurement scale in adult hospitalization units

“…The measurement of workloads through validated scales covering all the functions of the nursing discipline and using a standardized language such as nursing interventions with NIC terminology has shown, through the present study and other studies [ 3 , 7 , 20 ] that use this type of interventions, that the hours of care spent to each patient can be established. At the same time, it can make visible the sizing of the team who works in the health units [ 1 ], which is beneficial since it reflects all the activities performed during each work shift, whatever type they are.…”

“…Nursing workload, according to existing literature, can be considered as the amount of time, physical and cognitive effort, assumed by professionals to perform direct and indirect care activities, and those not directly associated with the patient [ 1 , 2 ]. This approach expands the concept of time dedicated to the demands of patients, since it also includes all the actions performed by the team during the process of caring and the time needed to execute the necessary interventions, not only in the care practice environment but also within the own professional development [ 1 , 3 , 4 ].…”

“…It is a complex phenomenon to measure, that is why it must be evaluated by objective, validated instruments and designed by the professionals themselves, taking also into consideration the care needs required by patients, those related to the management of the unit, the research and teaching development of healthcare professionals and taking into account the entire care system [ 1 , 5 ].…”

Além da classificação do paciente: a face “oculta” da carga de trabalho da enfermagem

“…Para agregar aos gestores a capacidade de olhar outras dimensões da CTE, desenvolveu-se e validou-se uma escala para a realidade brasileira contendo fatores e métodos de organização do trabalho: recursos disponíveis; trabalho em equipe; educação em serviço; plano e acompanhamento do cuidado; atenção ao paciente/familiar; e atendimento das necessidades identificadas. O instrumento pode contribuir, de forma prospectiva, na detecção de perigos, no planejamento de pessoal, na melhoria dos processos e no reconhecimento do produto entregue pela enfermagem, e, aliado aos SCP, pode auxiliar no planejamento da força de trabalho (30) .…”

“…Em outras palavras, permite avaliar pontos críticos que inviabilizam a entrega de um cuidado resiliente e seguro ou destacar cenários favoráveis para benchmarking. No entanto, não se propõe a mensurar o tempo direto dedicado às tarefas, e, portanto, recomenda-se a sua associação com o uso de um SCP validado (30) .…”