Patients' functioning as predictor of nursing workload in acute hospital units providing rehabilitation care: a multi-centre cohort study

Abstract

BackgroundManagement decisions regarding quality and quantity of nurse staffing have important consequences for hospital budgets. Furthermore, these management decisions must address the nursing care requirements of the particular patients within an organizational unit. In order to determine optimal nurse staffing needs, the extent of nursing workload must first be known. Nursing workload is largely a function of the composite of the patients' individual health status, particularly with respect to functioning status, individual need for nursing care, and severity of symptoms. The International Classification of Functioning, Disability and Health (ICF) and the derived subsets, the so-called ICF Core Sets, are a standardized approach to describe patients' functioning status. The objectives of this study were to (1) examine the association between patients' functioning, as encoded by categories of the Acute ICF Core Sets, and nursing workload in patients in the acute care situation, (2) compare the variance in nursing workload explained by the ICF Core Set categories and with the Barthel Index, and (3) validate the Acute ICF Core Sets by their ability to predict nursing workload.MethodsPatients' functioning at admission was assessed using the respective Acute ICF Core Set and the Barthel Index, whereas nursing workload data was collected using an established instrument. Associations between dependent and independent variables were modelled using linear regression. Variable selection was carried out using penalized regression.ResultsIn patients with neurological and cardiopulmonary conditions, selected ICF categories and the Barthel Index Score explained the same variance in nursing workload (44% in neurological conditions, 35% in cardiopulmonary conditions), whereas ICF was slightly superior to Barthel Index Score for musculoskeletal conditions (20% versus 16%).ConclusionsA substantial fraction of the variance in nursing workload in patients with rehabilitation needs in the acute hospital could be predicted by selected categories of the Acute ICF Core Sets, or by the Barthel Index score. Incorporating ICF Core Set-based data in nursing management decisions, particularly staffing decisions, may be beneficial.

How Nurses are Using the International Classifi cation of Functioning, Disability and Health: An Integrative Review

“…Evidence showed there are attempts to apply the ICF in clinical nursing practice in fourteen selected articles (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). In most articles (n=9), ICF application in clinical practice is defined in the Rehabilitation Nursing area (13,(15)(16)(17)(18)(19)(20)(21)26), directed primarily to nursing interventions (n=4) with patients in acute and post-acute situations requiring rehabilitation (13,17) and patients with spinal cord injury (16,21,26).…”

“…In most articles (n=9), ICF application in clinical practice is defined in the Rehabilitation Nursing area (13,(15)(16)(17)(18)(19)(20)(21)26), directed primarily to nursing interventions (n=4) with patients in acute and post-acute situations requiring rehabilitation (13,17) and patients with spinal cord injury (16,21,26).…”

“…Studies (17,19) highlighted the ICF contribution to nursing research through the development of Core Sets for nursing interventions (17) and rheumatoid arthritis (19), which may facilitate clinical practice implementation in the specific area of Rehabilitation Nursing.…”

Balancing nurses' workload in hospital wards: study protocol of developing a method to manage workload

“…Mueller et al 19 tested the correlation between the Barthel index scores and acute International Classification of Functions (ICF) core sets and nurses' workload. In this research, 20–44% of perceived nurses' workload variance is explained by these scores.…”

A ação social dos trabalhadores de enfermagem diante das restrições para o trabalho

“…Pesquisas recentes revelam que o elevado percentual de referência de dor musculoesquelética tem importante influência não somente para a vida do trabalhador doente como para o cotidiano de trabalho, ocasionando prejuízos à dinâmica de trabalho, seja pelas ausências ou pela presença no trabalho com restrições parciais para execução das atividades, ocasionadas pela dor crônica, pelo sofrimento psíquico e pelas variadas limitações decorrente do processo (Mueller et al, 2010;Silva, 2012;Vieira, Alcântara, 2013 (Baptista, 2014;Silva, Baptista, 2013).…”