title: Intrahospital transfers and the impact on nursing workload.
abstract: OBJECTIVE
  To determine the rate of patient moves and the impact on nurses' time.
  
  
  BACKGROUND
  Bed shortages and strategies designed to increase patient flow have led to a global increase in patient transfers between wards. The impact of transferring patients between wards and between beds within a ward on nurses' workload has not previously been measured.
  
  
  METHODS
  A two-stage sequential study. Retrospective analysis of hospital data and a prospective observational-timing study.
  
  
  METHODS
  Secondary analysis of an administrative data set to inform the rate of ward and bed transfers (n = 34,715) was undertaken followed by an observational-timing study of nurses' activities associated with patient transfers (n = 75).
  
  
  RESULTS
  Over 10,000 patients were moved 34,715 times in 1 year which equates to an average of 2.4 transfers per patient. On average, patient transfers took 42 min and bed transfers took 11 min of nurses' time. Based on the frequency of patient moves, 11.3 full-time equivalent nurses are needed to move patients within the site hospital each month.
  
  
  CONCLUSIONS
  Transferring patients is workload intensive on nurses' time and should be included in nursing workload measurement systems.
  
  
  CONCLUSIONS
  Nurses at the site hospital spend over 1700 hr each month on activities associated with transferring patients, meaning that less time is available for nursing care.
authors.affiliation: Centre for Health Services Management, Faculty of Health, University of Technology Sydney, Broadway, NSW, Australia.|Western Sydney University, Parramatta, NSW, Australia.
authors.forename: Nicole
authors.identifier: http://orcid.org/0000-0001-8515-4209
authors.initials: N
authors.lastname: Blay
authors.affiliation: Centre for Health Services Management, Faculty of Health, University of Technology Sydney, Broadway, NSW, Australia.|Mental Health Drug and Alcohol Nursing, Northern Sydney Local Health District, North Ryde, NSW, Australia.|School of Nursing, Midwifery & Paramedicine, Australian Catholic University, North Sydney, NSW, Australia.
authors.forename: Michael A
authors.identifier: http://orcid.org/0000-0002-3831-537X
authors.initials: MA
authors.lastname: Roche
authors.affiliation: Centre for Health Services Management, Faculty of Health, University of Technology Sydney, Broadway, NSW, Australia.|Nursing and Health Services Management, Edith Cowen University, Joondalup, WA, Australia.
authors.forename: Christine
authors.initials: C
authors.lastname: Duffield
authors.affiliation: Charles Perkins Centre, Sydney Nursing School, University of Sydney, Camperdown, NSW, Australia.
authors.forename: Robyn
authors.identifier: http://orcid.org/0000-0001-5588-9351
authors.initials: R
authors.lastname: Gallagher
mesh_terms: D000704:Analysis of Variance; D006742:Hospital Bed Capacity; D006801:Humans; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D010360:Patient Transfer / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012189:Retrospective Studies; D013996:Time and Motion Studies; D016526:Workload
keywords: intrahospital transfer; nurse workload; nursing activities; observational-timing study; secondary analysis; transfer