Share:


Managing human resources in nursing: the relationship of nurses’ working time and patients’ independence level

    Ramunė Čiarnienė Affiliation
    ; Roberta Suprikienė Affiliation
    ; Rūta Čiutienė Affiliation
    ; Asta Daunorienė Affiliation
    ; Olga Riklikienė Affiliation

Abstract

A skilled, competent, and motivated nursing workforce is crucial for a well-functioning health care system. Nurses’ professional activities done on a regular basis, their workload, and occupancy are related to the patient’s health status, dependence level and care needs. Therefore, managing human resources in nursing by effectively distributing nurses’ working time and monitoring their workload for safe and high quality care, managers should rely on the severity of patients’ health status and their independence level.


In this article the results on how nurses’ working time depends on patients’ independence are provided. The research was carried out at a regional hospital, in departments of medical profile. The time-and-motion study was implemented with 72 observations made in total, which amounted to 777.2 hours of nursing time. A questionnaire was used to assess the level of patients’ independence by assessing the four activities of the patient’s daily living. The results revealed that the largest amount of nurses’ working time, i.e. almost half of a day’s shift, was spent on direct patient care by administrating medication use and performing various nursing procedures. Nurses would spend almost half of the time for direct patient care on completely dependent patients, while one third would be spent on dependent patients. The relative number of nurses’ contacts with a patient is directly proportional to patient’s level of independence; a strong or fairly strong linear relationship was established betweenn the level of patients’ independence and the relative amount of nurses’ working time.

Keyword : nursing human resource management, nurses’ working time, workload management, patients’ classification systems, patient’s independence level

How to Cite
Čiarnienė, R., Suprikienė, R., Čiutienė, R., Daunorienė, A., & Riklikienė, O. (2019). Managing human resources in nursing: the relationship of nurses’ working time and patients’ independence level. Journal of Business Economics and Management, 20(1), 192-207. https://doi.org/10.3846/jbem.2019.8339
Published in Issue
Mar 4, 2019
Abstract Views
174
PDF Downloads
114
Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

References

Aiken, L. H., Sermeus, W., Van den Heede, K., Sloane, D. M., Busse, R., McKee, M., Bruyneel, L., Rafferty, A. M., Griffiths, P., Moreno-Casbas, M. T., Tishelman, C., Scott, A., Brzostek, T., Kinnunen, J., Schwendimann, R., Heinen, M., Zikos, D., Sjetne, I. S., Smith, H. L., & Kutney-Lee, A. (2012). Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. British Medical Journal, 344. https://doi.org/10.1136/bmj.e1717

Allen, D. (2004). Re-reading nursing and re-writing practice: towards an empirically based reformulation of the nursing mandate. Nursing Inquiry, 11, 271-283. https://doi.org/10.1111/j.1440-1800.2004.00234.x

Amendolair, D. (2012). Caring behaviors and job satisfaction. JONA, 42, 34-39. http://doi.org/10.1097/NNA.0b013e31823c18af

Ampt, A., Westbrook, J., Creswick, N., & Mallock, N. (2007). A comparison of self–reported and observational work sampling techniques for measuring time in nursing tasks. Journal of Health Services Research & Policy, 12(1), 18-24. http://doi.org/10.1258/135581907779497576

Ausserhofer, D., Zander, B., Busse, R., Schubert, M., De Geest, S., Rafferty, A. M., Ball, J., Scott, A., Kinnunen, J., Heinen, M., Strømseng Sjetne, I., Moreno-Casbas, T., Kózka, M., Lindqvist, R., Diomidous, M., Bruyneel, L., Sermeus, W., Aiken, L. H., & Schwendimann, R. (2014). Prevalence, patterns and predictors of nursing care left undone in European hospitals: results from the multicountry cross-sectional RN4CAST study. BMJ Quality and Safety, 23(2), 126-135. http://doi.org/10.1136/bmjqs-2013-002318

Baernholdt, M., Cox, K., & Scully, K. (2010). Using clinical data to capture nurse workload: implications for staffing and safety. Computers, Informatics, Nursing, 28(4), 229-234. http://doi.org/10.1097/NCN.0b013e3181e1e57d

Bray, K., Wren, I., Baldwin, A., St Ledger, U., Gibson, V., Goodman, S., & Walsh, D. (2010). Standards for nurse staffing in critical care units determined by: the British Association of Critical Care Nurses, The Critical Care Networks National Nurse Leads, Royal College of Nursing Critical Care and In-flight Forum. Nursing in Critical Care, 15(3), 109-111. http://doi.org/10.1111/j.1478-5153.2010.00392.x

Cadmus, E., & Wisniewska, E. K. (2013). Measuring first-line nurse manager work: instrument: development and testing. Journal of Nursing Administration, 43(12), 673-679. http://doi.org/10.1097/NNA.0000000000000010

Craker, N. C., Myers, R. A., Eid, J., Parikh, P., McCarthy, M. C., Zink, K., & Parikh, P. J. (2017). Nursing interruptions in a trauma intensive care unit: a prospective observational study. Journal of Nursing Administration, 47(4), 205-211. http://doi.org/10.1097/NNA.0000000000000466

Čiarnienė, R., Vienažindienė, M., & Vojtovic, S. (2017). Process improvement for value creation: a case of health care organization. Inzinerine Ekonomika-Engineering Economics, 28(1), 79-87. http://doi.org/10.5755/j01.ee.28.1.16601

Desjardins, F., Cardinal, L., Belzile, E., & McCusker, J. (2008). Reorganizing nursing work on surgical units: a time-and-motion study. Nursing Leadership, 21(3), 26-38. https://doi.org/10.12927/cjnl.2008.20057

Duffeld, C., Garder, G., & Catling-Paull, C. (2008). Nursing work and the use of nursing time. Journal of Clinical Nursing, 1, 3269-3274. http://doi.org/10.1111/j.1365-2702.2008.02637.x

Ejdys, J. (2015). Innovativeness of residential care services in Poland in the context of strategic orientation. Procedia – Social and Behavioral Sciences, 213, 746-752. https://doi.org/10.1016/j.sbspro.2015.11.461

European Federation of Nurses Associations. (2012, January). Caring in crisis: the impact of the financial crisis on nurses and nursing. A comparative overview of 34 European countries. Retrieved from http://www.efnweb.be/wp-content/uploads/2012/05/EFN-Report-on-the-Impact-of-the-Financial-Crisis-on-Nurses-and-Nursing-January-20122.pdf

Fagerstrom, L., Lonning, K., & Andersen, M. H. (2014). The RAFAELA system: a workforce planning tool for nurse staffing and human resource management. Nursing Management, 21(2), 30-36. https://doi.org/10.7748/nm2014.04.21.2.30.e1199

Fasoli, D. R., & Haddock, K. S. (2011). Results of an integrative review of patient classification systems. Annual Review of Nursing Research, 28, 295-316. https://doi.org/10.1891/0739-6686.28.295

Fouka, G., Plakas, S., Papageorgiou, D., Mantzorou, M., Kalemikerakis, I., & Vardaki, Z. (2013). The increase in illegal private duty nurses in public Greek hospitals. Journal of Nursing Management, 21(4), 633-637. https://doi.org/10.1111/j.1365-2834.2012.01409.x

Goldsworthy, S. (2016). Deteriorating work environments for critical care nurses: How urgent is this issue and what can be done? Nursing in Critical Care, 21(1), 6-7. https://doi.org/10.1111/nicc.12233

Harrison, J. (2004). Addressing increasing patient acuity and nursing workload. Journal of Nursing Management, 4(11), 20-26. https://doi.org/10.7748/nm2004.07.11.4.20.c1984

International Council of Nurses. (2017). International Classification for Nursing Practice (ICNP®). Retrieved from http://www.icn.ch/what-we-do/international-classification-for-nursing-practice-icnpr/

Kalisch, B. J., Landstrom, G. L., & Hinshaw, A. S. (2009). Missed nursing care: a concept analysis. Journal of Advanced Nursing, 65(7), 1509-1517. https://doi.org/10.1111/j.1365-2648.2009.05027.x

Kalisch, B., Tschanen, D., & Hyunhwa, L. (2011). Does missed nursing care predict job satisfaction? Journal Health Management, 56(2), 117-131.

Karabatsou, D., Tsironi, M., Tsigou, E., Boutzouka, E., Katsoulas, T., & Baltopoulos, G. (2016). Variable cost of ICU care, a micro-costing analysis. Intensive & Critical Care Nursing, 35, 66-73. https://doi.org/10.1016/j.iccn.2016.01.001

Lachowska, A. (2017). Efficiency of public and non-public primary health care providers in Poland. Engineering Management in Production and Services, 9(2), 57-63. https://doi.org/10.1515/emj-2017-0014

Malloch, K., & Conovaloff, A. (1999). Patient classification systems, Part 1: The third generation. Journal of Nursing Administration, 29(7/8), 49-56. https://doi.org/10.1097/00005110-199907000-00013

Martin, E., & Warshawsky, N. (2017). Guiding principles for creating value and meaning for the next generation of nurse leaders. Journal of Nursing Administration, 47(9), 418-420. https://doi.org/10.1097/NNA.0000000000000507

NANDA International. (n.d.). Defining the knowledge of nursing. Retrieved from http://www.nanda.org/

O’Brien, A. J., Abas, M., Christensen, J., Nicholis, P., Le Prou, T., Hekau, A., & Vanderpyl, J. (2002). Nursing workload measurement in acute mental health inpatient units. A report for the mental health research and development strategy. Auckland: Health Research Council of New Zealand. Retrieved from http://www.hrc/govt.nz/MHR&D

Patrician, P. A., Loan, L., McCarthy, M., Brosch, L. R., & Davey, K. S. (2010). Towards evidence-based management creating an informative database of nursing-sensitive indicators. Journal of Nursing Scholarship, 42(4), 358-366. https://doi.org/10.1111/j.1547-5069.2010.01364.x

Perroca, M. N., & Ek, A. C. (2007). Utilization of patient classification systems in Swedish hospitals and the level of satisfaction among nursing staff. Journal of Nursing Management, 15, 472-480. https://doi.org/10.1111/j.1365-2834.2007.00732.x

Porter-O’Grady, T., & Malloch, K. (2016). Leadership in nursing practice: changing the landscape of health care. Burlington, Massachusetts: Jones & Bartlett Learning.

Recio-Saucedo, A., Pope, C., Dall’Ora, C., Griffiths, P., Jones, J., Crouch, R., & Drennan, J. (2015). Safe staffing for nursing in emergency departments: evidence review. Emergency Medicine Journal, 32(11), 888-894. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/

Sermeus, W., Aiken, L. H., Van den Heede, K., Rafferty, A. M., Griffiths, P., Moreno-Casbas, M. T., Busse, R., Lindqvist, R., Scott, A. P., Bruyneel, L., Brzostek, T., Kinnunen, J., Schubert, M., Schoonhoven, L., & Zikos, D. (2011). Nurse forecasting in Europe (RN4CAST): Rationale, design and methodology. BioMed Central Nursing, 10(6), 1-9. https://doi.org/10.1186/1472-6955-10-6

Shu, Y. H., Ismail, N., Ong, L. C., & Kang, J. (2010). Determining nurse staffing needs: the workload intensity measurement system. Journal of Nursing Management, 18, 44-53. https://doi.org/10.1111/j.1365-2834.2009.01045.x

Smith, J. (2009). How to keep score of acuity and dependency. Journal of Nursing Management, 8(16), 14-19. https://doi.org/10.7748/nm2009.12.16.8.14.c7392

Squires, A. (2004). A dimensional analysis of role enactment of acute care nurses. Journal of Nursing Scholarship, 26, 272-278. https://doi.org/10.1111/j.1547-5069.2004.04049.x

Timmins, F., Parissopoulos, S., Plakas, S., & Fouka, G. (2017). Economic recession in Greece and effects on quality nursing care. Journal of Nursing Management, 25, 163-166. https://doi.org/10.1111/jonm.12477

Ulep, K. (2018). The nurse leader’s pivotal role in retaining millennial nurses. Journal of Nursing Administration, 48(12), 604-608. https://doi.org/10.1097/NNA.0000000000000689

Upenieks, V. V., Kotlerman, J., Akhavan, J., Esser, J., & Ngo, M. J. (2007). Assessing nursing staffing rations: variability in workload intensity. Policy, Politics, & Nursing Practice, 8(1), 7-19. https://doi.org/10.1177/1527154407300999

Virkstis, K., Herleth, A., & Langr, M. (2018). Cracks in the foundation of the care environment undermine nurse resilience. Journal of Nursing Administration, 48(12), 597-599. https://doi.org/10.1097/NNA.0000000000000687

Webster, J., Davies, H., Stankiewicz, M., & Fleming, L. C. (2011). Estimating the time involved in managing the “unoccupied bed”: a time and motion study. Nursing Economics, 29(6), 317-322.

Why nurse staffing matters. (2010). In Guidance on safe nursing staffing in the UK (pp. 14-19). Policy Unit, Royal College of Nursing. Retrieved from http://www.weds.wales.nhs.uk/sitesplus/docu-ments/1076/rcn%20safe%20staffing%20levels.pdf