Determining workload and size of nursing team in the pediatric emergency department

Abstract

Objective:To identify indicators of required nursing workload for pediatric patients care in an emergency department.Methods:This cross-sectional quantitative study was carried out in a pediatric short-stay unit at a public hospital in São Paulo (SP), Brazil. The patient classification system and activity times of nursing care proposed by the Brazilian Federal Nurse Council were applied to all patients admitted over a 1-month period. The instruments were applied by two nurses in populations of 500 and 453 patients, respectively. Nursing workload was calculated in terms of hours and by nurse/patient ratio. Data were analyzed by descriptive statistics, and inter- and intraobserver reliability was assessed by using Kappa coefficient. Confidence intervals were measured to verify differences in numbers of patient among work shifts.Results:The average daily workload was 108.7 hours and the average amount of time spent on nursing care per patient was 7.9 hours. The nurse-patient ratio was 1:2.6.Conclusion:The application of the standardized classification instrument was adequate. It enabled the classification of pediatric patients and the measurement of amount of time needed for nursing care. The average number of nursing work hours per patient met the average time for semi-intensive care established by the Brazilian Federal Nurse Council.

Assessment of the product of nursing care in specialized hospitals

“…The "dimensioning of nursing staff" considers the workload concerning the patients' needs and has an important influence on the security of healthcare (21) and the (dis)satisfaction of nursing professionals (22) . Most (6/8) evaluated this item as 3, that is, "the dimensioning of nursing staff is almost compatible with the workload and, for predicted or unpredicted absences, offers coverage through reassignments and/or extra hours of professional(s) with experience in the area."…”

Relationship between Work Ability Index and Cognitive Failure among Nurses

“…With regard to the findings of this study and Van den Burg et al’s study, in which it was stated that the effect of psychological factors on WAI was higher compared to lifestyle (physical), we concluded that there is a special relationship and interaction between work ability of nurses and their cognitive status ( 28 ). In addition, poor work ability of nurses in the emergency ward was the result of their high workloads, since in the study by Salavati et al, the high workload in the emergency ward was pointed out ( 29 ). Rotenburg mentioned a significant relationship between workload and insufficient work ability as well.…”

School Nurse Workload

“…Although nurse–patient ratio and nursing hours are correlated to workload in a small emergency holding area (Rossetti, Gaidzinski, & Bracco, 2014), a larger study of 23 nursing units in Belgium indicates that associated patient factors such as patient mobility and number of assistive personnel, are key workload factors when direct and indirect patient care is measured (Myny et al, 2012). Substituting professional registered nurses (RNs) with assistive personnel has been linked to poor patient outcomes and mortality.…”

“…Two of the studies (Nogueira, Domingues, Poggetti, & DeSousa, 2014; Queijo et al, 2013) appraise different ICU patient variables and measure nursing workload via Nursing Activity Scores (NAS). Rossetti, Gaidzinski, and Bracco (2014) study a cross-section of 943 pediatric patients in an emergency department and Steyrer, Huber, Valentin, and Strunk (2013) apply a prospective cross-sectional design to study safety and medication errors in the ICU. The only longitudinal study design (Badia et al, 2011) estimates how certain patient variables or indicators predicted nursing workload 1 year after admission into a home health-care agency.…”