title: A comparison of activities undertaken by enrolled and registered nurses on medical wards in Australia: an observational study.
abstract: BACKGROUND
  The past decade has seen increasing patient acuity and shortening lengths of stays in acute care hospitals, which has implications for how nursing staff organise and provide care to patients.
  
  
  OBJECTIVE
  The aim of this study was to describe the activities undertaken by enrolled nurses (ENs) and registered nurses (RNs) on acute medical wards in two Australian hospitals.
  
  
  METHODS
  This study used structured observation, employing a work sampling technique, to identify the activities undertaken by nursing staff in four wards in two hospitals. Nursing staff were observed for two weeks. The data collection instrument identified 25 activities grouped into four categories, direct patient care, indirect care, unit related activities and personal activities.
  
  
  METHODS
  Two hospitals in Queensland, Australia.
  
  
  RESULTS
  A total of 114 nursing staff were observed undertaking 14,528 activities during 482h of data collection. In total, 6870 (47.3%) indirect, 4826 (33.2%) direct, 1960 (13.5%) personal and 872 (6.0%) unit related activities were recorded. Within the direct patient care activities, the five most frequently observed activities (out of a total of 10 activities) for all classifications of nursing staff were quite similar (admission and assessment, hygiene and patient/family interaction, medication and IV administration and procedures), however the absolute proportion of Level 2 RN activities were much lower than the other two groups. In terms of indirect care, three of the four most commonly occurring activities (out of a total of eight activities) were similar among groups (patient rounds and team meetings, verbal report/handover and care planning and clinical pathways). The six unit related activities occurred rarely for all groups of nurses.
  
  
  CONCLUSIONS
  This study suggests that similarities exist in the activities undertaken by ENs and Level 1 RNs, supporting the contention that role boundaries are no longer clearly delineated.
authors.affiliation: Research Centre for Clinical and Community Practice Innovation, Griffith University, Gold Coast campus, Qld. 4222, Australia. W.Chaboyer@griffith.edu.au
authors.forename: Wendy
authors.initials: W
authors.lastname: Chaboyer
authors.forename: Marianne
authors.initials: M
authors.lastname: Wallis
authors.forename: Christine
authors.initials: C
authors.lastname: Duffield
authors.forename: Mary
authors.initials: M
authors.lastname: Courtney
authors.forename: Philippa
authors.initials: P
authors.lastname: Seaton
authors.forename: Kerri
authors.initials: K
authors.lastname: Holzhauser
authors.forename: Jessica
authors.initials: J
authors.lastname: Schluter
authors.forename: Nerolie
authors.initials: N
authors.lastname: Bost
mesh_terms: D001315:Australia; D006757:Hospital Units; D009741:Nursing Staff, Hospital; D015203:Reproducibility of Results