Abstract
ABSTRACTObjective: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.
Highlights
Nursing workload at hospital is related to care needs of patients and to standard of care intended,(1)
The application of the standard classification instrument was effective to determine both dependence degree and size of nursing staff according to COFEN resolution 293/04.(14) To date, there are no reports in the literature on the use of patient classification instrument by Dini et al[9] associated with OAP
The size of the nursing staff is directly associated with competence and experience of professionals as well as with degree of dependence and risks related to patients’ clinical conditions.[17]. Instruments to measure the degree of dependence among patients must be valid and reliable to guarantee patient safety and quality in nursing care
Summary
Nursing workload at hospital is related to care needs of patients and to standard of care intended,(1). Carayon and Alvarado[3] described seven interrelated dimensions associated with workload that involved quantitative and qualitative aspects such as patient care, working under temporal constraint, dealing with emotional issues and variability of the clinical picture. For this reason, the adequate number of nursing staff can create conditions to optimize workload. 218 Rossetti AC, Gaidzinski RR, Bracco MM dimensioning of staff increases workload and the impacts toward all dimensions in a cyclic manner, may to lead to compromised quality of care and affects the safety of patient and nursing professionals.[2,3]. Studies on nursing workload in different types of hospital units[4,5,6,7] have shown that the use of patient classification system (PCS) to determine the degree of dependence of the patient in nursing care enables to measure the amount of nursing workload needed for the care of patients with different ages.[8,9,10]
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