Measuring nurse workload in ambulatory care
نویسندگان
چکیده
nursing time required to care for patients. However, time is not the only factor to consider when measuring nursing workload, a prerequisite for developing ambulatory care nurse staffing models. For this reason , when nurses, managers, and administrators ask about the method for determining the levels and numbers of nursing staff appropriate for delivering quality care in the ambulatory setting, there is no magic solution. Many variables must be considered, and measured , when designing optimal ambulatory nurse staffing models. This is the first of two articles which will provide an overview of definitions and instruments for measuring nursing workload in ambulatory care. In the second article (to be published in an upcoming issue of Nursing Economic$), the use of these instruments for developing ambulatory nurse staffing models and their link with providing quality patient care will be discussed. Patient classification systems originated for utilization review purposes to analyze physician practice patterns and resource consumption of hospitalized patients (Arbitman, 1986). Selected patient classification systems are listed in Table 1. For nursing, patient classification and workload measurement developed to quantify and qualify the variable nature of the demand for nursing care. Nursing workload measurement systems grew out of a necessity to forecast the number of nurses required for care in hospitals on a daily basis. Systems typically include one or more instruments for measuring the time required for direct and indirect nursing care, selected ongoing infrastructure functions of the nursing organization, and the personal activities of the nurse (Edwardson & Giovannetti, 1994). Several comprehensive reviews of the literature relevant to acute care nursing workload measurement systems have been completed (Edwardson & Giovannetti, 1994). Terms used in nursing workload measurement include workload measurement system, nursing workload, patient classification systems, patient classification instruments, activity classification systems , and timed activity classification systems (see Table 2). Review of nursing workload measurement and comparability of instruments in the ambulatory care setting has received limited attention in the literature over the past 25 years.O VER THE PAST 30 YEARS, there has been rapid development of measurement systems for health services resource allocation in the United States, not always matched by using the same definition of concepts, not consistently based on any assessment of reliability or validity and/or thorough understanding of the phenomenon being measured. An example is the development of nursing workload measurement systems for ambulatory care. Although substantial differences exist among the measurement approaches, at …
منابع مشابه
Linking nursing workload and performance indicators in ambulatory care.
More and more ambulatory care organizations are using nursing report cards to monitor and evaluate the quality and effectiveness of nursing care in the ambulatory setting. Nurse staffing levels is usually one of the items included in a nursing report card and the one most scrutinized by ambulatory care administrators. One strategy employed by the nursing leadership at the South Texas Veterans H...
متن کاملAmbulatory Care Nurse-Sensitive Indicators Series: Reaching for the Tipping Point in Measuring Nurse-Sensitive Quality in the Ambulatory Surgical and Procedure Environments.
The value of the ambulatory care nurse remains undocumented from a quality and patient safety measurement perspective and the practice is at risk of being highly variable and of unknown quality. The American Academy of Ambulatory Care Nursing and the Collaborative Alliance for Nursing Outcomes propose nurse leaders create a tipping point to measure the value of nursing across the continuum of n...
متن کاملAmbulatory care registered nurse performance measurement.
On March 1-2, 2010, a state-of-the-science invitational conference titled "Ambulatory Care Registered Nurse Performance Measurement" was held to focus on measuring quality at the RN provider level in ambulatory care. The conference was devoted to ambulatory care RN performance measurement and quality of health care. The specific emphasis was on formulating a research agenda and developing a str...
متن کاملComparison of agreement between different measures of blood pressure in primary care and daytime ambulatory blood pressure.
OBJECTIVE To assess alternatives to measuring ambulatory pressure, which best predicts response to treatment and adverse outcome. SETTING Three general practices in England. DESIGN Validation study. PARTICIPANTS Patients with newly diagnosed high or borderline high blood pressure; patients receiving treatment for hypertension but with poor control. MAIN OUTCOME MEASURES Overall agreemen...
متن کاملCost-effectiveness of nurse practitioners in primary and specialised ambulatory care: systematic review
OBJECTIVE To determine the cost-effectiveness of nurse practitioners delivering primary and specialised ambulatory care. DESIGN A systematic review of randomised controlled trials reported since 1980. DATA SOURCES 10 electronic bibliographic databases, handsearches, contact with authors, bibliographies and websites. INCLUDED STUDIES Randomised controlled trials that evaluated nurse practi...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره شماره
صفحات -
تاریخ انتشار 2010