Time and quality of admissions: nursing workload

Repercussions of moving patients on the context of practice: perspectives of the nursing team

OBJECTIVE

to examine the nursing team's view of the repercussions of moving patients (admissions, transfers and discharges) on the organization of work and the delivery of care.

METHOD

this is a qualitative study using the focus group technique, conducted with 23 professionals - 12 nurses, eight nurse technicians and three nurse assistants working in three inpatient units at a teaching hospital in the countryside of Sao Paulo. Four meetings took place between November 2021 and March 2022. The reports were analyzed thematically using MAXQDA software.

RESULTS

two thematic categories emerged: the influence of structural factors and work organization on the intra-hospital moving of patients; it demands time, generates work overload and interferes with the delivery of care.

CONCLUSION

the volume of moving patient associated with unforeseen demands, care complexity and insufficient staff and resources have a negative impact on the delivery of care, with clinical risks and work overload. The findings make it possible to improve the regulation of patients entering and leaving the units, work organization and care management, avoiding clinical risks, delays, omissions and work overload.

BACKGROUND

(1) Moving patients around the hospital requires structure and work organization.

BACKGROUND

(2) Nursing estimates dedicating 10-15 minutes to 2-3 hours of work on these interventions.

BACKGROUND

(3) Frequency, unpredictability and complexity of care have a negative impact on care.

BACKGROUND

(4) Unfavorable conditions for moving generate care and occupational risks.

SIZING OF NURSING STAFF IN CLINICAL, SURGICAL AND PEDIATRIC HOSPITALIZATION UNITS

ABSTRACT Objective: to size the Nursing staff in clinical, surgical and pediatric inpatient units. Method: a retrospective cross-sectional study, carried out in a university hospital in Midwest Brazil. The data were obtained from daily classifications of the care complexity level (n=5,808) among patients (n=882) hospitalized in the referred units, from July to October 2019, in addition to occupancy and hospital stay indicators. Descriptive statistical analysis, parameters and an equation specific to the design were used. Results: clinical hospitalization had the highest occupation, permanence, demand for Nursing hours/day (162.58) and deficit of nurses (-12), followed by the pediatric unit (-2). In the clinical and surgical units, there was the same available/real number of nurses. The general staff sized showed personnel surplus (+24), due to the high number of mid-level professionals in all the sectors. Conclusion: expected sizing inadequacy was verified, as there was a mismatch between workload and allocation of professionals in the units.