Methods of quantifying workload: how the quantitative workload of ICU nurses can be studied

Abstract

Methods for quantifying the intensive care unit (ICU) workload of nurses originate from the Time and Motion Studies that were introduced in 1930s. In those days, interest in the most-efficient way to manufacture products increased. Therefore, methods to develop scientifically based time standards for tasks and to monitor delay in production were needed [1]. Time and Motion Studies were part of the Scientific Management Movement that tried to improve production levels by scientific methods. To some extent, the problem with ICUs is comparable. They consume large amounts of nursing manpower and in order to manage the costs of ICUs, ICU managerial staff need figures about the average, or standard time needed to perform nursing tasks in different patients. Current studies that aim to quantify ICU workload of nurses, that is to compute their time consumption [2, 3], resemble the Time Studies originating from Scientific Management. In both cases, the statistical method of work sampling is applied. But there is also a sharp difference between the rather technical approach of the Time Studies and the approach to understand the time consumption of ICU nurses. Recently, there has been an increased interest in the different elements of an ICU nurse’s work [2–4]. Researchers and staff agree that the serious condition of ICU patients and the particular setting of ICUs require interventions related to high technology of an ICU. But also specific physical (e.g., safety, comfort, activation, and lifting tasks) and social (e.g., support and communication with patient, contact with family, and other disciplines) assistance is necessary. This implies that in order to study the quantitative workload of ICU nurses, not only the method of measuring and computing time is of great significance. Also the method by which nurses’ activities that comprise their workload are selected, is important.