The Barthel Index Scale as an Indicator of Nursing Workload

Abstract

Background: The Barthel Index (BI) is a standardized tool used to evaluate patients’ ability to perform daily activities. Lower scores on the index indicate greater dependency. The distribution of nursing workload is often uneven and rarely assessed using validated measures, particularly on busy days, such as those following patient admission days when care demands are higher. Purpose: This study aims to quantify nursing workload in two hospital wards using the Barthel Index. Methods: This cross-sectional comparative study collected patient data through direct observation and interviews with all patients in two hospital wards in northern Greece on a busy working day. The 10-item BI was employed to determine each patient’s level of dependency. Results: A total of 62 patients (31 females; mean age 74.5 years, range 20–94) participated in this study. Ward A had 12 nurses, while ward B had 13. On a heavy workday, the mean BI score was 45 in ward A and 20 in ward B, indicating higher patient dependency in Ward B. Conclusion: The BI provides a quick and objective assessment of patient dependency, which reflects nursing workload. Integrating BI assessments into routine practice could support evidence-based staffing decisions and allow for better alignment of nurse allocation with the specific needs of each ward, especially during high-demand periods.