title: The examination of nursing work through a role accountability framework.
abstract: OBJECTIVE
  To use work analysis data to describe the amount of time registered nurses (RNs) and health care aides (HCA) spent on key clinical role accountabilities and other work activities.
  
  
  BACKGROUND
  Health care providers are not effectively utilized. To improve their efficiency and effectiveness, it is necessary to understand how nursing providers enact their role accountabilities.
  
  
  METHODS
  Using palm pilot Function Analysis technology, observers recorded the activities of 35 registered nurse and 17 health care aides shifts on a second-by-second basis over 5 days. Work activities were classified using the Nursing Role Effectiveness Model, which conceptualizes nursing practice in terms of clinical role accountabilities.
  
  
  RESULTS
  The registered nurses spent a considerable amount of time on bio-medical assessment/surveillance, relatively little time was spent on patient and family psycho-social-cultural-spiritual assessment/surveillance and support.
  
  
  CONCLUSIONS
  Unlike other work sampling studies, this research project examined nursing work within a role accountability framework; an important first step in the call for the measurement of the impact of nursing care.
  
  
  CONCLUSIONS
  Changes to how registered nurses and health care aides enact their role will require a clear vision by unit managers and their staff of their role accountabilities, and the gap between ideal and actual practice.
authors.affiliation: Workforce Research and Evaluation, Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: Deborah E
authors.initials: DE
authors.lastname: White
authors.affiliation: Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Jackson
authors.affiliation: Health Systems and Workforce Research Unit, Calgary Health Region, Calgary, Alberta, Canada.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Besner
authors.affiliation: Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Jill M
authors.initials: JM
authors.lastname: Norris
mesh_terms: D000416:Alberta; D006801:Humans; D016294:Models, Nursing; D024802:Nurse's Role; D009741:Nursing Staff, Hospital / Q000523:psychology*; D012941:Social Responsibility; D013647:Task Performance and Analysis; D017132:Workplace
keywords: health care aides; nursing; role accountability; work activities; work sampling