| Learning Objective #1: Discuss how ratios of nurse staffing and components of nurse staffing affect the amount of RN time spent in direct care | |||
| Learning Objective #2: Discuss how research using this type of framework will begin to identify some of the effects of nurse staffing on the delivery of patient care |
Objective: to explore the relationships between nurse staffing and the percentage of time registered nurses spend in direct and indirect care.
Design: longitudinal, multifactorial research design, consisting of 70 days by 5 units by 3 shifts.
Sample: all nursing personnel
Setting: 5 inpatient acute care units in a community hospital.
Year: 70 days during 2001.
Variables: Independent: ratio of RNs to LPNs and RNs to total nursing staff; patient-to-nurse ratio. Dependent: percentage of time RNs spent in direct and indirect care. Direct care was defined as time RNs spent in a patient room or in the hallway outside of a patient room or in the medication room, indirect care was defined as time RNs spent at the nursing station. All variables were adjusted by unit acuity.
Methods: electronic data files that captured second to second recordings of physical locations of nursing personnel were downloaded and merged with a daily staffing data base that contained all nursing personnel working on each of 5 units. After data cleaning procedures were completed, statistical analyses were conducted using SPSS.
Findings: The average percentage of time RNs spent in direct care was 54%, indirect care was 42%. RNs spent 31.5% more time in direct care as the proportion of RN hours increased by 1. As the hours of unit secretary increased by 1, the percentage of time RNs spent in direct care increased by 2.7%.
Conclusions: The study findings indicate that RN time is driven by the proportion of RN hours in the skill mix, and highlights the important contribution the unit secretary makes in allowing RNs to spend more time in direct care.
Implications: These study findings may clarify how nurse staffing impacts allocation of RN time and may be an explanatory factor that explains the established linkage between nurse staffing and patient outcomes.
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Back to 14th International Nursing Research Congress
Sigma Theta Tau International
10-12 July 2003