Determination of standard times of nursing activities based on a Nursing Minimum Dataset

Aim: This paper is a report of a study conducted to determine the standard time per nursing activity and the proportion of nursing time covered by the nursing activities of the B-NMDS-2 compared to the total time of a nurse shift, and to evaluate the correlation between hospital size and standard times of nursing activities. Background: Due to a shrinking workforce and rising workload, nursing managers need tools that help them to allocate their staff to the wards. Such tools should be based on objective time measurements. Methods: The study was performed in surgical, internal medicine and elder care wards in an acute hospital care setting. In the first phase, a two-round Delphi-procedure was used to operationalise the definitions of nursing activities. In the second phase, the standard time for each nursing activity was determined, based on data collected over a 6-month period during 2006-2007. A combination of 13,292 work sampling observations by external observers, 3000 recordings of direct time measurement by self-recording and subjective time assessments yielded times that were used to analyse the duration of the nursing activities. Results: A standard time for 102 nursing activities was established. The coverage of the B-NMDS-2 in the surgical, elder care and internal medicine wards was 47.5%, 46.4% and 51.0% respectively. The Belgian Nursing Minimum Dataset (B-NMDS-2) was found to cover almost 70% of direct and indirect nursing care. Conclusion: Further research is needed to assess the impact on the standard times of nursing activities of inefficient organisational structures and different cultural interpretations of the way an activity is conducted