Nursing workload and staff allocation in an Italian hospital: a quality improvement initiative based on nursing care score
Aim: To develop, implement, and evaluate a Nursing Care Score (NCS) system, built into the electronic health record, to optimize nursing workload and staff allocation. Design: A quality improvement (QI) initiative with a pre- and post-implementation design was conducted by an interprofessional team...
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| Format: | Article |
| Language: | English |
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University of Ostrava
2016-05-01
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| Series: | Central European Journal of Nursing and Midwifery |
| Subjects: | |
| Online Access: |
http://periodika.osu.cz/cejnm/dok/2016-02/10-giammona-et-al.pdf
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| _version_ | 1818855368996945920 |
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| author | Santa Giammona Giuseppe Arena Michelangelo Calò Maria Angela Barone Davide Scelsa Andrea Lepre Maria Rosaria Tarantino Elizabeth A. Schlenk |
| author_facet | Santa Giammona Giuseppe Arena Michelangelo Calò Maria Angela Barone Davide Scelsa Andrea Lepre Maria Rosaria Tarantino Elizabeth A. Schlenk |
| author_sort | Santa Giammona |
| collection | DOAJ |
| description | Aim: To develop, implement, and evaluate a Nursing Care Score (NCS) system, built into the electronic health record, to optimize nursing workload and staff allocation. Design: A quality improvement (QI) initiative with a pre- and post-implementation design was conducted by an interprofessional team in the 33-bed cardio-thoracic unit of a 72-bed hospital in Palermo, Italy. Methods: A seven-phase process was used to develop, implement, and evaluate the NCS, which lists 53 nursing work tasks, each assigned a score from 1.5 to 5.0. The nurse-to-patient ratio on all shifts was determined by the NCS. Nurse satisfaction with both the existing system and the NCS workload system was assessed. Descriptive statistics and McNemar's test were used to analyze the data. Results: At pre-implementation, 92.5% of nurses reported that the existing system was not effective, 87.5% reported it did not enable them to provide adequate nursing care, and 20.0% believed that workload was fairly distributed. At post-implementation, 75.0% of nurses reported that the NCS system was effective (p = 0.0348), 85.0% reported that the NCS system enabled them to provide adequate care, and 85.0% believed that workload was fairly distributed. An NCS score of 65 ± 5 was found to distribute workload most fairly. Conclusion: An automatic electronic operating system to generate a daily workload report based on the NCS was successfully implemented and evaluated. The NCS provided relevant information to guide nurse managers in defining nurse-to-patient ratio and determining staff allocation. Nurses were satisfied with the NCS system. The steps used to develop, implement, and evaluate the NCS system may be transferable to other units and other hospitals. |
| first_indexed | 2024-12-19T08:07:30Z |
| format | Article |
| id | doaj.art-f0161b8bc9224e76aec70d172b083a71 |
| institution | Directory Open Access Journal |
| issn | 2336-3517 2336-3517 |
| language | English |
| last_indexed | 2024-12-19T08:07:30Z |
| publishDate | 2016-05-01 |
| publisher | University of Ostrava |
| record_format | Article |
| series | Central European Journal of Nursing and Midwifery |
| spelling | doaj.art-f0161b8bc9224e76aec70d172b083a712022-12-21T20:29:44ZengUniversity of OstravaCentral European Journal of Nursing and Midwifery2336-35172336-35172016-05-017242042710.15452/CEJNM.2016.07.0010CEJNM.2016.07.0010Nursing workload and staff allocation in an Italian hospital: a quality improvement initiative based on nursing care scoreSanta Giammona0Giuseppe Arena1Michelangelo Calò2Maria Angela Barone3Davide Scelsa4Andrea Lepre5Maria Rosaria Tarantino6Elizabeth A. Schlenk7 Department of Nursing Services, IRCCS-ISMETT, Palermo, Italy Department of Nursing Services, IRCCS-ISMETT, Palermo, Italy Department of Nursing Services, IRCCS-ISMETT, Palermo, Italy Quality Services, IRCCS-ISMETT, Palermo, Italy Department of MD Services, IRCCS-ISMETT, Palermo, Italy Department of Nursing Services, IRCCS-ISMETT, Palermo, Italy Department of Nursing Services, IRCCS-ISMETT, Palermo, Italy School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania Aim: To develop, implement, and evaluate a Nursing Care Score (NCS) system, built into the electronic health record, to optimize nursing workload and staff allocation. Design: A quality improvement (QI) initiative with a pre- and post-implementation design was conducted by an interprofessional team in the 33-bed cardio-thoracic unit of a 72-bed hospital in Palermo, Italy. Methods: A seven-phase process was used to develop, implement, and evaluate the NCS, which lists 53 nursing work tasks, each assigned a score from 1.5 to 5.0. The nurse-to-patient ratio on all shifts was determined by the NCS. Nurse satisfaction with both the existing system and the NCS workload system was assessed. Descriptive statistics and McNemar's test were used to analyze the data. Results: At pre-implementation, 92.5% of nurses reported that the existing system was not effective, 87.5% reported it did not enable them to provide adequate nursing care, and 20.0% believed that workload was fairly distributed. At post-implementation, 75.0% of nurses reported that the NCS system was effective (p = 0.0348), 85.0% reported that the NCS system enabled them to provide adequate care, and 85.0% believed that workload was fairly distributed. An NCS score of 65 ± 5 was found to distribute workload most fairly. Conclusion: An automatic electronic operating system to generate a daily workload report based on the NCS was successfully implemented and evaluated. The NCS provided relevant information to guide nurse managers in defining nurse-to-patient ratio and determining staff allocation. Nurses were satisfied with the NCS system. The steps used to develop, implement, and evaluate the NCS system may be transferable to other units and other hospitals. http://periodika.osu.cz/cejnm/dok/2016-02/10-giammona-et-al.pdf nursing carenursing workloadnursing care scorestaff allocationpatient outcomes |
| spellingShingle | Santa Giammona Giuseppe Arena Michelangelo Calò Maria Angela Barone Davide Scelsa Andrea Lepre Maria Rosaria Tarantino Elizabeth A. Schlenk Nursing workload and staff allocation in an Italian hospital: a quality improvement initiative based on nursing care score Central European Journal of Nursing and Midwifery nursing care nursing workload nursing care score staff allocation patient outcomes |
| title | Nursing workload and staff allocation in an Italian hospital: a quality improvement initiative based on nursing care score |
| title_full | Nursing workload and staff allocation in an Italian hospital: a quality improvement initiative based on nursing care score |
| title_fullStr | Nursing workload and staff allocation in an Italian hospital: a quality improvement initiative based on nursing care score |
| title_full_unstemmed | Nursing workload and staff allocation in an Italian hospital: a quality improvement initiative based on nursing care score |
| title_short | Nursing workload and staff allocation in an Italian hospital: a quality improvement initiative based on nursing care score |
| title_sort | nursing workload and staff allocation in an italian hospital a quality improvement initiative based on nursing care score |
| topic | nursing care nursing workload nursing care score staff allocation patient outcomes |
| url |
http://periodika.osu.cz/cejnm/dok/2016-02/10-giammona-et-al.pdf
|
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