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


METHODS
A work sampling study was conducted during 2004. A snapshot of nursing activity was recorded at 5-minute intervals from 0600 to 2355 spread over 2 weeks, with one session from 0600 to 1525 and the second from 1530 to 2355.


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.


CONCLUSIONS
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.
Williams
Heather
H
Northwick Park Hospital, Regional Rehabilitation Unit, London, UK. heather.williams@nwlh.nhs.uk
Harris
Ruth
R
Turner-Stokes
Lynne
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D003625:Data Collection / Q000379:methods; D006801:Humans; D008875:Middle Aged; D009422:Nervous System Diseases / Q000451:nursing / Q000534:rehabilitation; D024802:Nurse's Role; D015401:Nursing Administration Research / Q000379:methods; D009741:Nursing Staff, Hospital / Q000458:organization & administration; D012047:Rehabilitation Centers / Q000458:organization & administration; D019145:Rehabilitation Nursing / Q000458:organization & administration / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis; D000078329:Workforce; D016526:Workload / Q000706:statistics & numerical data*; D055815:Young Adult