Care and noncare-related activities among critical care nurses: A cross-sectional observational time and motion study

Abstract

Background: Measurement of nursing activities is used for workload assessment, performance evaluation, and workforce management. Objectives: This study aimed to measure care and noncare-related activities among critical care nurses and to determine their contributing factors. Methods: This cross-sectional observational study was conducted from July to September 2017. All care and noncare-related activities of 70 critical care nurses in a public university hospital in Kashan, Iran, were assessed through the time and motion technique. Each nurse was observed throughout a 6-h morning shift. Data were collected using a nurse and patient characteristics questionnaire and care and noncare-related activities checklist. The paired and the independent-samples t-test, Mann-Whitney U-test, Kruskal-Wallis tests, and the one-way analysis of variance were used for data analysis. Results: The duration of nurses' care-related activities (249.10 ± 65.00 min, i.e., 69.2% of a 6-h shift) was significantly more than the duration of their noncare-related activities (111.00 ± 48.30 min, i.e., 30.8% of a 6-h shift). Respecting care-related activities, participants spent 53.5% of their time on direct care and the rest 46.5% on indirect care; whereas respecting noncare-related activities, they spent 76.5% of their time on personal activities (such as making personal calls) and the rest 23.5% on unit related tasks. The duration of nurses' activities had significant relationships with their unit, nurse-patient ratio, and patients' age, gender, and diagnosis. Conclusion: Critical care nurses spend their time mostly on care-related than noncare-related activities. Closer managerial supervision of nurses' activities, in-service educations about effective time management, and determination of the optimum nurse-patient ratio and the best task division schedule are needed to reduce nurses' workload, improve care quality, and enhance patient satisfaction.