Validation of standard times and influencing factors during the development of the Workload Indicator for Nursing

Background. The value of a tool to assist in optimal allocation of available nursing resources is paramount. Aims. This paper is a report of a study with the goals (1) to determine whether the standard times of the Belgian Nursing Minimum Dataset (B-NMDS-2) are a valid basis for the development of a workload measurement tool; (2) to determine the impact of factors that influence nursing workload most; and (3) to examine the impact of one item on the time of another item of the B-NMDS-2. Methods. The data of this prospective study was collected during September 2010 in a convenience sample of 23 nursing units in four hospitals in Belgium. The data collection included three parts: the registration of (1) the items of the B-NMDS-2; (2) the time of direct patient care; and (3) variables which influence the nursing workload at patient and unit level. Results. The correlations between the sum of Direct and Indirect Patient Care and the Workload Indicator for Nursing-score of the surgical, internal medicine and intensive care units were respectively 0.85, 0.88 and 0.89. Significant differences in standard times for nursing activities at the patient-level are found, influenced by the level of need for mobility support. Units needing significantly more time for DIPC than predicted by the WiN-score, had a higher mean number of complex nursing activities per patient. Conclusions. The high correlation coefficients between the total time of direct patient care and the WiN-score, indicate that the standard times of the B-NMDS-2 are valid