Determining workload and size of nursing team in the pediatric emergency department

Abstract

OBJECTIVE: To identify indicators of required nursing workload for pediatric patients care in an emergency department. METHODS: This cross-sectional quantitative study was carried out in a pediatric short-stay unit at a public hospital in São Paulo (SP), Brazil. The patient classification system and activity times of nursing care proposed by the Brazilian Federal Nurse Council were applied to all patients admitted over a 1-month period. The instruments were applied by two nurses in populations of 500 and 453 patients, respectively. Nursing workload was calculated in terms of hours and by nurse/patient ratio. Data were analyzed by descriptive statistics, and inter- and intraobserver reliability was assessed by using Kappa coefficient. Confidence intervals were measured to verify differences in numbers of patient among work shifts. RESULTS: The average daily workload was 108.7 hours and the average amount of time spent on nursing care per patient was 7.9 hours. The nurse-patient ratio was 1:2.6. CONCLUSION: The application of the standardized classification instrument was adequate. It enabled the classification of pediatric patients and the measurement of amount of time needed for nursing care. The average number of nursing work hours per patient met the average time for semi-intensive care established by the Brazilian Federal Nurse Council.