Nursing workload measurement instrument : Validity, Reliability and Applicability

The management of the thorax centre of the UMCG needs a good insight in personnel, equipment and materials needed to provide the necessary quality of care. It is hard to determine the number of nurses that are needed in future time periods. The management decided to develop a workload measurement instrument, in which every action a nurse performs on a specific patient is documented, aiming to get more insight in the personnel needed. After two years of using the instrument a group of students from the University of Groningen were asked to evaluate the instrument. They suggested that the validity and the reliability of the measurement instrument are questionable. This led to the following research question: What are the validity, reliability and the applicability of the measurement instrument used by the thorax centre of the UMCG? In order to answer this question different research methods were applied. Firstly, a literature review was performed leading to the requirements which an applicable measurement instrument needs to meet. The nursing workload measurement instrument of the UMCG is in this thesis tested against each of these requirements. After the literature review the data needed to answer these sub questions was obtained using observations, interviews and the historic data of the measurement instrument. Six of the nurses of the thorax centre were observed during a dayshift and interviewed after that dayshift. During these observations every activity of the nurse was documented and timed. The gathered data was later compared to the historical data collected with the current nursing workload measurement instrument. Analysis of the collected data leads to the conclusion that the nursing workload measurement instrument is not reaching its full potential. The activities listed in the measurement instrument are not fully covering the definition of nursing work and the operation time of each of these items are not matching the actual times needed by the nurses. Therefore, the current measurement instrument is not supporting the decision making process of the management. However, the measurement instrument has potential. When the measurement instrument is improved the management will have a useful tool to support their budget requests and get insight in the nursing work on their wards.