title: Balancing nurses' workload in hospital wards: study protocol of developing a method to manage workload.
abstract: Hospitals pursue different goals at the same time: excellent service to their patients, good quality care, operational excellence, retaining employees. This requires a good balance between patient needs and nursing staff. One way to ensure a proper fit between patient needs and nursing staff is to work with a workload management method. In our view, a nursing workload management method needs to have the following characteristics: easy to interpret; limited additional registration; applicable to different types of hospital wards; supported by nurses; covers all activities of nurses and suitable for prospective planning of nursing staff. At present, no such method is available.
  
  
  
  The research follows several steps to come to a workload management method for staff nurses. First, a list of patient characteristics relevant to care time will be composed by performing a Delphi study among staff nurses. Next, a time study of nurses' activities will be carried out. The 2 can be combined to estimate care time per patient group and estimate the time nurses spend on non-patient-related activities. These 2 estimates can be combined and compared with available nursing resources: this gives an estimate of nurses' workload. The research will take place in an academic hospital in the Netherlands. 6 surgical wards will be included, capacity 15-30 beds.
  
  
  
  The study protocol was submitted to the Medical Ethical Review Board of the University Medical Center (UMC) Utrecht and received a positive advice, protocol number 14-165/C.
  
  
  
  This method will be developed in close cooperation with staff nurses and ward management. The strong involvement of the end users will contribute to a broader support of the results. The method we will develop may also be useful for planning purposes; this is a strong advantage compared with existing methods, which tend to focus on retrospective analysis.
authors.affiliation: University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: W F J M
authors.initials: WF
authors.lastname: van den Oetelaar
authors.affiliation: University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: H F
authors.initials: HF
authors.lastname: van Stel
authors.affiliation: Center for Human Resource Organization and Management Effectiveness, Business University Nyenrode, Breukelen, The Netherlands.|ArboNed Occupational Health Service, Utrecht, The Netherlands.
authors.forename: W
authors.initials: W
authors.lastname: van Rhenen
authors.affiliation: University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: R K
authors.initials: RK
authors.lastname: Stellato
authors.affiliation: University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: W
authors.initials: W
authors.lastname: Grolman
mesh_terms: D000046:Academic Medical Centers; D013502:General Surgery; D006801:Humans; D009426:Netherlands; D009732:Nursing Care / Q000379:methods*; D009741:Nursing Staff, Hospital; D010561:Personnel Staffing and Scheduling; D012107:Research Design; D012189:Retrospective Studies; D000072358:Work-Life Balance; D016526:Workload
keywords: nurse workload; staff planning; workload management