Nursing Workload and Staff Allocation in Labor Unit within the Changing Context
Article Sidebar
Main Article Content
Abstract
This mixed-methods study aimed to: 1) analyze workload; 2) explore factors associated with perception of workload; and 3) study perspective towards workload and working conditions of registered nurses and practical nurses working in the labor room. The sample consisted of 24 registered nurses and 10 practical nurses based on the inclusion criteria. Quantitative data were collected by Recording Form, Demographic Data Questionnaire, and the Questionnaire of the Experience and Evaluation of Work (QEEW). Qualitative data was collected from 13 informants using interview guideline regarding the workload, working conditions and the impact on their wellbeing. Quantitative data were analyzed by descriptive statistics, Pearson’s and Spearman’s correlation coefficient, and Chi-square test. Qualitative data were analyzed by content analysis. Results show that the main workload was related to caesarean section (77.70%), which required nurse to patient ratio of 2.5:1. The most perception of workload by staffs was an urgent work. Then, they perceived as physical strenuous work and amount of work consecutively. Age of the respondents was found as the factor associated with workload perception (r =.43, p <.05). The respondents’ perspectives toward workload and well-being were generated into three themes: 1) burnout due to overwork; 2) under staffs-too much work-have to juggling; and 3) needed to manage even though over workload. Results showed that the respondents perceived overwork due to under staffs allocation. There is the need to allocate proper staffs to work ratio of the labor room.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Van Den Oetelaar WFJM, Van Stel HF, Van Rhenen W. Balancing nurses’ workload in hospital wards: study protocol of developing a method to manage workload. BMJ Open 2016; 6: 1-11.
Liu LF, Lee S, Chia PF. Exploring the association between nurse workload and nurse-sensitive patient safety outcome indicators. J Nurs Res 2012; 20: 300-9.
Lynn U. Nurse Staffing and Patient, Nurse, and Financial outcomes. Am J Nurs 2008; 108: 62-71.
Peter G, Christina S, Jane B, Jeremy J, Natalie P, Thomas M. Nursing workload, nurse staffing methodologies and tools: A systematic scoping review and discussion. Int J Nurs Stud 2020; 103:1-11.
Richard JH, Matthew CS, Neal RP, Rainu K, Kamisha HE, Roger LB, et al. A human factors framework and study of the effect of nursing workload on patient safety and employee quality of working life. BMJ Qual Saf 2011; 20(1): 15-24.
Krisada S. Crisis of nursing shortage in health service Facilities under Office of Permanent Secretary, Ministry of Public Health: Policy Recommendations. J Health Sci 2017; 26: 457-68. (In Thai)
Chloe D. Nurses are the ‘backbone’ of healthcare and the world is six million shorts, declares WHO [Internet]. 2020 [updated April 2020]. Available from: https:// nursingnotes.co.uk/news/workforce/nurses-backbone-healthcare-world-million-shortdeclares
Mudaly P, Nkosi ZZ. Factors influencing nurse absenteeism in a general hospital in Durban, South Africa. J Nurs Manage 2015; 23: 23-31.
E H, Pirjo P, Katri VJ. Nursing activities, nurse staffing and adverse patient outcomes as perceived by hospital nurses. J Clin Nurs 2011; 21: 1584-93.
Dries M, Dirk VG, Micheline G, Katrien V, Ann VH, Tom D. Non-direct patient care factors influencing nursing workload: a review of the literature. J Adv Nurs 2011; 67(10): 2109-29.
Valda VU, Jenny K, Jaleh A, Jennifer E, Myha JN. Assessing nursing staffing ratios: variability in workload intensity. Policy, Politics and Nursing Practice 2007; 8(1): 7-19.
Hoi SY, Ismail N, Ong LC, Kang J. Determining nurse staffing needs: the workload intensity measurement system. J Nurs Manage 2010; 18:44-53.
Behdin N, Nancy L, Lorraine C, Michel L, Ellen R, Diane BG. Workplace system factors of obstetric nurses in Northeastern Ontario, Canada: Using a Work Disability Prevention Approach. Safety and Health at Work 2015; 6(4): 305-11.
Marc Van Veldhoven, Jan Prins, Paul van der Laken, L. Dijkstra. QEEW2.0: 42 short scales for survey research on work, well-being and performance. Amsterdam: SKB; 2015.
Williams GH, Anderson JJ. Developing a labor and delivery patient classification system. J Nurs Manage 1992; 23: 74-80.
Thailand Nursing and Midwifery Council. Standard of nursing and midwifery service organization. In: Ministry of Public Health, Nonthaburi: Thailand Nursing and Midwifery Council 2006;180-5. (In Thai)
Virginia B, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006; 3: 77-101.
Nitaya R. Nursing Personnel Staffing in Delivery Room According to Workload: A Case Study of Ramathibodi Hospital [dissertation]. Bangkok:Chulalongkorn University; 2003.
Wilhelmina FJM, Willem VR, Rebecca KS, Wilko G. Balancing workload of nurses: Linear mixed effects modelling to estimate required nursing time on surgical wards. Nursing Open 2019; 7: 235-45.
Buja A, Zampieron A, Mastrangelo G, Petean M, Vinelli A, Cerne D ea. Strain and health implications of nurses’ shift work. Int J Occup Med Env 2014;26 :4.
Madsen JB, Kaila A, Julkunen KV, Miettinen M. Time allocation and temporal focus in nursing management: an integrative review. J Nurs Manage 2016; 24(8): 983-93.
Dries M, Ann VH, Dirk DB, Sofie V, Micheline G, Tom D, et al. Determining a set of measurable and relevant factors affecting nursing workload in the acute care hospital setting: A cross-sectional study. Int J Nurs Stud 2012; 49: 427-36.
Mchugh MD, Lake ET. Understanding clinical expertise: nurse education, experience, and the hospital context. Res Nurs Health 2011; 33(4):276–87.
Lu Y, Hu XM, Huang XL, Zhuang XD, Guo P, Feng LF, et al. Job satisfaction and associated factors among healthcare staff: a cross-sectional study in Guangdong Province, China. BMJ Open 2016; 6(7):1-9.