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Work sampling: a quantitative analysis of nursing activity in a neuro-rehabilitation setting

Authors

  • Heather Williams,

    1. Heather Williams MSc RN Research Assistant Northwick Park Hospital, Regional Rehabilitation Unit, London, UK
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  • Ruth Harris,

    1. Ruth Harris MSc PhD RN Senior Researcher Kingston University and St George’s, University of London, Faculty of Health and Social Care Sciences, London, UK
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  • Lynne Turner-Stokes

    1. Lynne Turner-Stokes DM FRCP Professor and Director of the Regional Rehabilitation Unit Herbert Dunhill Chair of Rehabilitation King’s College London School of Medicine, Department of Palliative Care, Policy and Rehabilitation, London, UK
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H. Williams: e-mail: heather.williams@nwlh.nhs.uk

Abstract

Title. Work sampling: a quantitative analysis of nursing activity in a neuro-rehabilitation setting.

Aim.  The aim of this investigation was to establish the distribution and proportion of nursing activity represented by patient-related care activities (direct and indirect), and other nursing activities (unit-related and personal) within one inpatient neurological rehabilitation unit.

Background.  A set of tools has been developed for estimating the care/nursing hours required for direct hands-on patient care in hospital rehabilitation settings. However, to apply this information to estimate the actual staffing requirements in relation to a given caseload, it is necessary to know the proportion of nursing workload assigned to other activities and how this may vary throughout the day.

Method.  A work sampling study was conducted during 2004. A snapshot of nursing activity was recorded at 5-minute intervals from 06·00 to 23·55 spread over 2 weeks, with one session from 06·00 to 15·25 and the second from 15·30 to 23·55.

Results.  A total of 8883 nursing activities were observed and recorded over 126 hours and categorized as follows: 4060 (46%) direct patient care, 2218 (25%) indirect patient care, 874 (10%) unit-related and 1731 (19%) personal time. The proportions of direct care fluctuated throughout the day, with direct care activities mainly concentrated in early mornings and to a lesser extent evenings.

Conclusion.  Direct patient care accounted for less than half of the nursing activity in a rehabilitation setting. Estimates of staffing requirement must also take account of the time required for indirect care and non-patient related activity.

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