Using Clinical Data to Capture Nurse Workload

Abstract

The purpose of this project was to demonstrate how a hospital clinical database can be utilized to calculate individual nursing unit activities that affect nurses' workload. While research has established that staffing is associated with patient safety, few studies have examined ways to measure nurse workload and its impact on patient safety. The widely used midnight census does not account for the number of patients who occupy a bed in a 24-hour period. In this study, a hospital clinical data repository was used to calculate workload measures such as total treated patients, midnight census, and admission, discharges, and transfers, as well as a unit activity index. Unit activity indexes for intensive care and medical-surgical units were compared over time, by shift, day of week, and month. Admission, discharges, and transfers varied according to unit type. During 1994 to 2006, unit activity index increased. Fluctuations in unit activity index were noted according to shift, day of week, and month. Hospital clinical data repositories can be used to calculate workload measures, and these measures should be incorporated with other traditional measures in making staffing decisions.

Crime Clearance and Temporal Variation in Police Investigative Workload: Evidence from National Incident-Based Reporting System (NIBRS) Data

“…However, we also recognize that these measures do not capture all facets of the workload concept, possibly influencing our results. Even daily measures may obscure finer-grained temporal variation in workload-in the health context, see Norrish and Rundall (2001) and Baernholdt et al (2010)-and our measures do not recognize changes in the number of available personnel, or the possibility of differential changes in workload in different parts of an agency (Waegel 1981;Paré et al 2007). No existing data source tracks changing police staffing levels at better than annual precision, much less the actual availability of staff at a particular moment across many jurisdictions.…”

Status of costing hospital nursing work within Australian casemix activity‐based funding policy

“…There remains wide variation in approaches and measures to source nursing workload. For instance, hospital data such as midnight census, total treated patients, admission, discharges and transfers and a unit activity index have been used to calculate workload measures 31 . A nurse costing application used a measurement of nursing intensity of nursing care using the ‘clinical care classification system’ 32…”

Intrahospital transfers and the impact on nursing workload

“…Demand for healthcare services is increasing. In Australia as elsewhere, a high patient turnover associated with Emergency Department (ED) presentations, shorter hospital lengths of stay, the ageing population and increasing rates of chronic disease (ABS, ; AIHW, , ) have added to nurses’ workload pressures and demands on their time (Baernholdt, Cox, & Scully, ; Myny et al., ). Despite the increased demands for care, the number of public hospital beds per 1,000 Australian population has declined by 0.9% since 2008/2009 (AIHW, ) meaning that more patients need to be accommodated in fewer hospital beds.…”