Nursing workload in the emergency department: a methodological proposal

Rossetti, Ana Cristina; Gaidzinski, Raquel Rapone; Fugulin, Fernanda María Togeiro

doi:10.1590/s0104-11692013000700028

Cited by 15 publications

(14 citation statements)

References 9 publications

(13 reference statements)

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“…The findings of this study show that the number of nurses is lacking, because the emergency room of the São Paulo Hospital has only one registered nurse per shift, however, the non-registered nursing assistants staff for each 6 hour shift is appropriate (having four non-registered nursing assistants). A study found a mathematical calculation to obtain the workload present in the emergency room units using the average number of patients or procedures performed as variables and the score obtained by the application of the Nursing Activities Score, and another calculation for the shock room using the average number of patients or procedures used and the average length of service in the area (23) . This study proposes a methodology for obtaining nursing measurements, but uses an unvalidated instrument for the emergency area.…”

Section: Discussionmentioning

confidence: 99%

Nursing staff sizing in the emergency room of a university hospital

Paixão

Campanharo

Lopes

et al. 2015

Rev. esc. enferm. USP

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Objective: To verify the adequacy of the professional nursing staff in the emergency room of a university hospital and to evaluate the association between categories of risk classification triage with the Fugulin Patient Classification System. Method: The classification of patients admitted into the emergency room was performed for 30 consecutive days through the methodology proposed by Gaidzinski for calculating nursing requirements. Results: The calculation determines the need for three registered nurses and four non-registered nursing for each six hour shift. However, only one registered nurse and four non-registered nurse were available per shift. There was no correlation between triage risk classification and classification of care by the Fugulin Patient Classification System. Conclusion: A deficit in professional staff was identified in the emergency room. The specificity of this unit made it difficult to measure. To find the best strategy to do so, further studies should be performed. Nursing staff sizing in the emergency room of a university hospital Dimensionamento de enfermagem em sala de emergência de um hospital-escola Dimensionamiento de enfermería en servicio de urgencias de un hospital escuela

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Section: Discussionmentioning

confidence: 99%

Nursing staff sizing in the emergency room of a university hospital

Paixão

Campanharo

Lopes

et al. 2015

Rev. esc. enferm. USP

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“…Such studies, however, are time-intensive and do not guarantee that the documented activities or the recording periods are representative for nursing work (Pelletier & Duffield, 2003). Rossetti, Rapone Gaidzinski, and Fugulin (2013) used different strategies or instruments according to eight different ED areas (e.g.…”

Section: Backg Rou N Dmentioning

confidence: 99%

“…Rossetti, Rapone Gaidzinski, and Fugulin () used different strategies or instruments according to eight different ED areas (e.g. shock room, medication room, suturing room).…”

Section: Introductionmentioning

confidence: 99%

Development and validation of an assessment tool for nursing workload in emergency departments

Iordache

Elseviers

Cock

et al. 2019

Journal of Clinical Nursing

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Aims To develop the Workload Assessment of Nurses on Emergency (WANE) tool and to test its validity and reliability to measure nursing workload in the emergency departments. Background Ensuring safe nursing staffing in emergency departments is a worldwide concern. There is no valid tool to measure emergency nursing workload in order to determine the needed nurse staffing in the emergency departments. Design A two‐year, cross‐sectional, multicenter study. Methods Workload was operationalised as the time nurses spent with nursing activities, classified into direct and indirect care. A board of experts provided content validity. Construct validity was evaluated by examining the WANE's correlations and group‐discriminations patterns within the network of variables known to determine nursing workload. Reliability was assessed by the tool's ability to yield consistent results across repeated measurements. Reporting of this research adheres to STROBE guidelines. Results Seven emergency departments, including 3,024 patients, were involved in the first year and 18 emergency departments and 7,442 patients in the second year. Direct care time correlated positively and significantly with patient dependency on nursing care, age and length of emergency department stay and discriminated between the categories of dependency on nursing care, age and hospitalisation. Both direct and indirect care time discriminated between the emergency departments according to different patient care profiles and unit characteristics. WANE showed consistent results across measurements. Conclusions Results support the WANE's reliability and validity to measure emergency nursing workload. This tool could be used to determine, on patient and unit, a baseline nurse staffing and the nursing skill mix in the emergency departments. WANE is also an evidence‐based management tool for benchmarking purposes. Relevance to clinical practice The use of an evidence‐based workload tool in making staffing decisions in emergency departments is crucial to ensure safe patient care and prevent work overload in nursing staff.

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“…Limitations in organisational resources and facilities, as well as staff mismatches can exacerbate the problem. Manpower resource limitations in nursing has been cited as one of the most prevalent problems of health care systems globally (Aiken et al., ; Rossetti, Gaidzinski, & Fugulin, ). Service heterogeneity related to the delivery of care to patients with diverse needs in acute care hospitals, as well as the co‐production nature of nursing care together with diverse patient groups, would result in a highly variable and complex care delivery system.…”

Section: Introductionmentioning

confidence: 99%