The Balancing Act

Storfjell, Judith Lloyd; Omoike, Osei; Ohlson, Susan

doi:10.1097/01.nna.0000312771.96610.df

Cited by 34 publications

(7 citation statements)

References 24 publications

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“…On the positive side, the study found that 25.5% of the time of the nursing unit managers is spent on patient care. Although this proportion compares well with the findings of studies among nurses providing direct care in high-income countries ( 17 , 19 , 20 , 24 , 33 ), this proportion might not be appropriate in light of the core management responsibilities of nursing unit managers. The study also found that unit managers experienced numerous interruptions, performing many short, fragmented tasks.…”

Section: Discussionmentioning

confidence: 44%

“…Similarly a Belgian study found that nurses spent 32.2% of their time on direct patient care ( 24 ), while a similar proportion of 32.8% was found in a Montreal hospital study among surgical nurses ( 17 ). The 1934 US study found that ‘head nurses’ or unit managers spent around 15.6% of their time on direct patient care ( 30 ), while another US study found that nurses spent 44% of their time on patient care ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

“…Notwithstanding the importance and commonality of time as an economic resource available to all managers ( 16 ), most of the time and motion studies have been conducted among doctors and nurses providing direct care to patients ( 17 – 26 ). The focus of these studies has been on: the relationship between nursing time and quality of care ( 20 , 23 , 27 ); interruptions in nursing tasks and the association with adverse clinical events ( 21 , 28 ); or to determine the time taken for various nursing tasks in specific nursing units to enable staff planning ( 17 – 19 , 23 – 26 , 29 ). The findings of these studies suggest that there is a positive association between the amount of time nurses spend with patients and patient or nurse satisfaction, as well as patient outcomes and safety ( 17 – 21 ).…”

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confidence: 99%

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The activities of hospital nursing unit managers and quality of patient care in South African hospitals: a paradox?

Armstrong

Rispel

Penn‐Kekana

2015

Global Health Action

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BackgroundImproving the quality of health care is central to the proposed health care reforms in South Africa. Nursing unit managers play a key role in coordinating patient care activities and in ensuring quality care in hospitals.ObjectiveThis paper examines whether the activities of nursing unit managers facilitate the provision of quality patient care in South African hospitals.MethodsDuring 2011, a cross-sectional, descriptive study was conducted in nine randomly selected hospitals (six public, three private) in two South African provinces. In each hospital, one of each of the medical, surgical, paediatric, and maternity units was selected (n=36). Following informed consent, each unit manager was observed for a period of 2 hours on the survey day and the activities recorded on a minute-by-minute basis. The activities were entered into Microsoft Excel, coded into categories, and analysed according to the time spent on activities in each category. The observation data were complemented by semi-structured interviews with the unit managers who were asked to recall their activities on the day preceding the interview. The interviews were analysed using thematic content analysis.ResultsThe study found that nursing unit managers spent 25.8% of their time on direct patient care, 16% on hospital administration, 14% on patient administration, 3.6% on education, 13.4% on support and communication, 3.9% on managing stock and equipment, 11.5% on staff management, and 11.8% on miscellaneous activities. There were also numerous interruptions and distractions. The semi-structured interviews revealed concordance between unit managers’ recall of the time spent on patient care, but a marked inflation of their perceived time spent on hospital administration.ConclusionThe creation of an enabling practice environment, supportive executive management, and continuing professional development are needed to enable nursing managers to lead the provision of consistent and high-quality patient care.

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Section: Discussionmentioning

confidence: 44%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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The activities of hospital nursing unit managers and quality of patient care in South African hospitals: a paradox?

Armstrong

Rispel

Penn‐Kekana

2015

Global Health Action

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“…As it has become more common for nursing units to be understaffed and/or overworked (Anderson, 2007;Hassmiller & Cozine, 2006;Shindul-Rothschild, Berry, & Long-Middleton, 1996), it is important to consider how nursing staff can potentially use their time more efficiently and more effectively (Hendrich, Chow, Skierczynski, & Lu, 2008;Storfjell, Omoike, & Ohlson, 2008). One of the most desired goals in acute care is to increase the amount of time a nurse is able to interact with and directly care for a patient.…”

Section: Nurse Presence In Patient Roomsmentioning

confidence: 98%

To see or not to see: Investigating the links between patient visibility and potential moderators affecting the patient experience

Bosch

Apple²,

Hiltonen³

et al. 2016

Journal of Environmental Psychology

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“…This is in line with the findings of a study by Mark et al, which stated that costs were increased when many registered nurses were hired in the hospital [ 9 ]. Nonetheless, although the salary of registered nurses was high and found to contribute to the high cost of treatment, knowledgeable and highly skilful nurses are important for a positive patient outcome [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

The development of inpatient cost and nursing service weights in a tertiary hospital in Malaysia

Hassan

Aljunid

Nur

2020

BMC Health Serv Res

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Background The current healthcare sector consists of diverse services to accommodate the high demands and expectations of the users. Nursing plays a major role in catering to these demands and expectations, but nursing costs and service weights are underestimated. Therefore, this study aimed to estimate the nursing costs and service weights as well as identify the factors that influence these costs. Methods A retrospective cross-sectional descriptive study was conducted at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) using 85,042 hospital discharges from 2009 to 2012. A casemix costing method using the step-down approach was used to derive the nursing costs and service weights. The cost analysis was performed using the hospital data obtained from five departments of the UKMMC: Finance, Human Resource, Nursing Management, Maintenance and Medical Information. The costing data were trimmed using a low trim point and high trim point (L3H3) method. Results The highest nursing cost and service weights for medical cases were from F-4-13-II (bipolar disorders including mania - moderate, RM6,129; 4.9871). The highest nursing cost and service weights for surgical cases were from G-1-11-III (ventricular shunt - major, RM9,694; 7.8880). In obstetrics and gynaecology (O&G), the highest nursing cost and service weights were from O-6-10-III (caesarean section - major, RM2,515; 2.0467). Finally, the highest nursing cost and service weights for paediatric were from P-8-08-II (neonate birthweight > 2499 g with respiratory distress syndrome congenital pneumonia - moderate, RM1,300; 1.0582). Multiple linear regression analysis showed that nursing hours were significantly related to the following factors: length of stay (β = 7.6, p < 0.05), adult (β = − 6.0, p < 0.05), severity level I (β = − 3.2, p < 0.05), severity level III (β = 7.3, p < 0.05), male gender (β = − 4.2, p < 0.05), and the elderly (β = − 0.5, p < 0.05). Conclusions The results showed that nursing cost and service weights were higher in surgical cases compared to other disciplines such as medical, O&G and paediatric. This is possible as there are significant differences in the nursing activities and work processes between wards and specialities.

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The Balancing Act

Cited by 34 publications

References 24 publications

The activities of hospital nursing unit managers and quality of patient care in South African hospitals: a paradox?

The activities of hospital nursing unit managers and quality of patient care in South African hospitals: a paradox?

To see or not to see: Investigating the links between patient visibility and potential moderators affecting the patient experience

The development of inpatient cost and nursing service weights in a tertiary hospital in Malaysia

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