Understanding the work of intensive care nurses: A time and motion study

Abbey, M; Chaboyer, Wendy; Mitchell, Marion

doi:10.1016/j.aucc.2011.08.002

Cited by 76 publications

(98 citation statements)

References 161 publications

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“…Also, nurses must perform nursing procedures, assist with medical procedures, manipulate chest and mediastinal tubes to ensure patency, document patient progress, enter and retrieve computer data, interact with the family, supervise the nursing team, transport the patient when needed, check and re-stock supplies, and keep the environment clean (10)(11) . Given these multiple activities, knowledge of institutional risk factors for a serious complications -RBC transfusion -should direct nursing care.…”

Section: Discussionmentioning

confidence: 99%

“…Given the existence of multiple possible risk factors for RBC, a question arises regarding the context of the institution where this study was developed: what are the predictive factors for RBC transfusion after cardiac surgery? Knowledge of the institutional risk factors should aid nurses in prioritizing vigilance for complications considering high-risk patients, since these professionals must perform multiple and simultaneous activities upon patient admission to the ICU after cardiac surgeries (10)(11) . In addition to prioritizing vigilance, implementation of strategies to minimize blood transfusion relies on nursing actions that require knowledge of institutional risk factors; these should not be routinely performed as mechanical activities.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of red blood cell transfusion after cardiac surgery: a prospective cohort study

Lopes

Brunori

Cavalcante

et al. 2015

Rev. esc. enferm. USP

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Objective: To identify predictors of red blood cell transfusion (RBCT) after cardiac surgery. Method: A prospective cohort study performed with 323 adults after cardiac surgery, from April to December of 2013. A data collection instrument was constructed by the researchers containing factors associated with excessive bleeding after cardiac surgery, as found in the literature, for investigation in the immediate postoperative period. The relationship between risk factors and the outcome was assessed by univariate analysis and logistic regression. Results: The factors associated with RBCT in the immediate postoperative period included lower height and weight, decreased platelet count, lower hemoglobin level, higher prevalence of platelet count <150x10 3 /mm 3 , lower volume of protamine, longer duration of anesthesia, higher prevalence of intraoperative RBCT, lower body temperature, higher heart rate and higher positive end-expiratory pressure. The independent predictor was weight <66.5Kg. Conclusion: Factors associated with RBCT in the immediate postoperative period of cardiac surgery were found. The independent predictor was weight.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predictors of red blood cell transfusion after cardiac surgery: a prospective cohort study

Lopes

Brunori

Cavalcante

et al. 2015

Rev. esc. enferm. USP

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“…The present study has advanced knowledge by providing more detailed information about each direct care activity. Nursing managers may use this knowledge to estimate staff workload, make decisions on task re-allocation 4 and staffing levels, 9 evaluate the impact of implemented changes 4 and develop strategies to optimise care processes.…”

Section: Common Findings At Both Racfsmentioning

confidence: 99%

“…5 In addition, this knowledge will set the baseline for examining the impact of any implemented change, 4 such as introduction of an electronic information system. [6][7][8] Furthermore, such details are important in informing public policy or managerial decision on staffing levels, 9 either for newly built aged care facilities or existing facilities in which resident case mix has changed.…”

Section: Introductionmentioning

confidence: 99%

Time spent on daytime direct care activities by personal carers in two Australian residential aged care facilities: a time–motion study

Qian¹,

Yu²,

Hailey³

et al. 2014

Aust. Health Review

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Objective. To examine the time, frequency and duration of each direct care activity conducted by personal carers in Australian residential aged care homes. Methods. A time-motion study was conducted to observe 46 personal carers at two high-care houses in two facilities (14 days at Site 1 and 16 days at Site 2). Twenty-three direct care activities were classified into eight categories for analysis. Results. Overall, a personal carer spent approximately 45% of their time on direct care, corresponding to 3.5 h in an 8-h daytime shift. The two sites had similar ratios of personal carers to residents, and each resident received 30 min of direct care. No significant differences between the two sites were found in the time spent on oral communication, personal hygiene and continence activities. Personal carers at Site 1 spent significantly less time on toileting and mobility activities than those at Site 2, but more time on lunch activity. Although oral communication took the longest time (2 h), it occurred concurrently with other activities (e.g. dressing) for 1.5 h. Conclusions. The findings provide information that may assist decision makers in managing the operation of highcare residential aged care facilities, such as planning for task allocation and staffing. AbstractObjective. To examine the time, frequency and duration of each direct care activity conducted by personal carers in Australian residential aged care homes.Methods. A time-motion study was conducted to observe 46 personal carers at two highcare houses in two facilities (14 days at Site 1 and 16 days at Site 2). Twenty-three direct care activities were classified into eight categories for analysis.Results. Overall, a personal carer spent approximately 45% of their time on direct care, corresponding to 3.5 h in an 8-h daytime shift. The two sites had similar ratios of personal carers to residents, and each resident received 30 min of direct care. No significant differences between the two sites were found in the time spent on oral communication, personal hygiene and continence activities. Personal carers at Site 1 spent significantly less time on toileting and mobility activities than those at Site 2, but more time on lunch activity. Although oral communication took the longest time (2 h), it occurred concurrently with other activities (e.g. dressing) for 1.5 h.Conclusions. The findings provide information that may assist decision makers in managing the operation of high-care residential aged care facilities, such as planning for task allocation and staffing.

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“…For example, a study reported that energy expenditure for physical activity performed on the working days of clinical nurses was 1.5 times more than that of most office workers [1]. Studies using motion analysis found that the routine work of nurses is characterized by assuming a standing position for long periods of time and by frequently changing the body posture throughout the working time [2,3]. This indicates that it might be advantageous for nurses to have a high tolerance to orthostasis because, if tolerance is low, the ability to perform their duties could be diminished.…”

Section: Introductionmentioning

confidence: 99%

Arterial blood pressure response to head-up tilt test and orthostatic tolerance in nurses

Onizuka

Niimi²,

Sato

et al. 2015

Environ Health Prev Med

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Objectives High tolerance to postural changes was examined in nurses. Methods Twelve female nurses and 12 healthy controls underwent a 70°head-up tilt (HUT) test for 10 min. Blood pressure (BP), heart rate (HR), pulse pressure, and hormone levels were measured. Baroreceptor sensitivity (BRS) was calculated using a sequence technique. Results HR increased during HUT in both subject groups, with no difference between groups. Systolic BP was rapidly increased by HUT in both subject groups, and was higher in the nurse group than in the control group during the first 2 min of HUT. Pulse pressure decreased during 1-2.5 min of HUT in the control group, but there was no decrease in the nurse group. BRS was decreased by HUT in the nurse group, while it tended to be decreased in the control group. Both during baseline and HUT, BRS was lower in the nurse group than in the control group. Plasma noradrenaline increased with HUT, and the increase was greater in the nurse group than in the control group. Conclusions Although nurse subjects had a lower BRS during HUT than control subjects, they were able to effectively maintain BP during HUT, suggesting that nurse subjects had higher orthostatic tolerance. The better maintenance of BP in nurse subjects appeared to be associated with a compensatory mechanism other than the arterial baroreflex and/or a hemodynamic mechanism.

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Understanding the work of intensive care nurses: A time and motion study

Abstract: This study provides baseline evidence on the activities nurses undertake on a daily basis, with only about a quarter of their time not being spent on patient care activities, either directly or indirectly.

Cited by 76 publications

References 161 publications

Predictors of red blood cell transfusion after cardiac surgery: a prospective cohort study

Predictors of red blood cell transfusion after cardiac surgery: a prospective cohort study

Time spent on daytime direct care activities by personal carers in two Australian residential aged care facilities: a time–motion study

Arterial blood pressure response to head-up tilt test and orthostatic tolerance in nurses

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