title: Using clinical data to capture nurse workload: implications for staffing and safety.
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.
authors.affiliation: School of Nursing, University of Virginia, Charlottesville, VA 22908-0782, USA. mb2vy@virginia.edu
authors.forename: Marianne
authors.initials: M
authors.lastname: Baernholdt
authors.forename: Kathleen
authors.initials: K
authors.lastname: Cox
authors.forename: Ken
authors.initials: K
authors.lastname: Scully
mesh_terms: D001509:Bed Occupancy / Q000706:statistics & numerical data; D003625:Data Collection / Q000379:methods*; D016208:Databases, Factual / Q000706:statistics & numerical data; D006751:Hospital Information Systems / Q000458:organization & administration*; D006801:Humans; D020380:Needs Assessment; D015401:Nursing Administration Research; D009741:Nursing Staff, Hospital / Q000600:supply & distribution*; D010343:Patient Admission / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D010360:Patient Transfer / Q000706:statistics & numerical data; D010562:Personnel Staffing and Scheduling Information Systems / Q000458:organization & administration*; D017751:Safety Management / Q000458:organization & administration; D012621:Seasons; D015144:Southeastern United States; D013996:Time and Motion Studies; D016526:Workload / Q000706:statistics & numerical data*