Table 1 Estimates of time required to provide direct clinical nursing care within units participating in SAMBA19
From: Nurse staffing levels within acute care: results of a national day of care survey
Activity | Approximate time per task | Frequency of task of task in 24 h period | Estimate of applicable patients (% = proportion estimated to require task) | Total attributable time (hours) | Task appropriate for non-registered staff appropriate |
|---|---|---|---|---|---|
Admissions (n = 6423) | |||||
Admission assessment | 20 mins | Once | 3212 | 1070 | No |
Complex admission assessment) | 30 mins | Once | 3211 | 1605 | No |
Discharge planning / inter hospital transfer (n = 3372) (based on AMU turnover 75% and bed occupancy 90% | |||||
Simple follow up and transfer home | 10 mins | Once | 2530 (75%) | 421 | No |
Coordination of different services | 20mins | Once | 749 (20%) | 225 | No |
Organizing complex services, support and equipment | 30mins | Once | 126 (5%) | 63 | No |
Patient escort (based on 5% of AMU patients requiring escort during AMU stay) | |||||
Radiology / endoscopy | 30 mins | Once | 224 | 112 | No |
Procedures, treatments and end-of-life care (based on number of AMU beds and 90% occupancy) | |||||
Simple wound dressing, specimen collection | 10 mins | Once | 4048 (90%) | 674 | Yes |
Nasogastric tube insertion. Catheterisation, Multiple simple dressings | 20 mins | Once | 249 (5%) | 75 | No |
Complex wound management | 30 mins | Once | 50 (1%) | 22 | No |
Care after death | 30 mins | Once | 250 (2.5%) | 56 | No |
Observations (n = 4997) (based on AMU bed numbers, NEWS2 [31] and bed occupancy 90%) | |||||
Routine (4 to 6 hourly) | 10 mins | Four | 3598 (NEWS2 < 5) | 2399 | Yes |
Increased (2 to 4 hourly) | 10 mins | Six | 674 (NEWS2 5–6) | 674 | Yes |
> 2 hourly | 10 mins | Twelve | 224 (NEWS2 ≥ 7) | 450 | Yes |
Medication administration (based on AMU bed numbers and bed occupancy 90%) | |||||
Regular oral | 10 mins | Four | 4498 | 2998 | No |
IV or frequent PRN | 20 mins | Three | 3598 (80%) | 3598 | No |
Medication requiring complex preparation (2 nursing staff) eg controlled drugs | 30 mins | Two | 404 (10%) | 448 | No |
Direct contact and communication (based on AMU bed numbers and bed occupancy 90%) | |||||
Routine | 10 mins | Once | 2249 (50%) | 375 | No |
Significant | 30 mins | Once | 2249 (50%) | 1125 | No |
Eating and drinking (based on AMU bed numbers and 90% bed occupancy) | |||||
Assistance | 20mins | Three | 2263 (50%) | 2263 | Yes |
Parenteral | 30mins | Three | 49 (1%) | 67 | No |
Fluid management (based on AMU bed numbers and 90% bed occupancy) | |||||
8 hourly IV fluids | 10 mins | Three | 1357 (30%) | 679 | No |
IV fluid > 8 hourly or blood products | 20 mins | Four | 452 (10%) | 602 | No |
Complex fluid management (such as hourly fluid balance) | 10 mins | Twenty-four | 899 (10%) | 1810 | No |
Management of equipment (based on AMU bed numbers and 90% bed occupancy) | |||||
Simple intermittent (catheter, IV access) | 10 mins | Once | 4273 (95%) | 712 | No |
Drains / stomas / central lines | 20 mins | Three | 225 (5%) | 225 | No |
Ventilatory support (including NIV) | 30 mins | Twenty-four | 44 (1%) | 539 | No |
Mobilisation (based on AMU bed numbers and 90% bed occupancy) | |||||
Assistance needed | 20 mins | Four | 1799 (40%) | 2399 | Yes |
Assistance of two nursing staff required | 30 mins | Four | 449 (10%) | 899 | Yes |
Skin and pressure areas care (based on AMU bed numbers and 90% bed occupancy) | |||||
2–4 hourly | 20 mins | Five | 449 (10%) | 831 | Yes |
More frequently than 2 hourly | 30 mins | Twelve | 250 (5%) | 1350 | Yes |
Toileting (based on AMU bed numbers and 90% bed occupancy) | |||||
Assistance needed | 20 mins | Four | 1799 (40%) | 2399 | Yes |
Frequent assistance of > 2 nursing staff required | 30 mins | Four | 449 (10%) | 899 | Yes |
Washing, bathing and dressing (based on AMU bed numbers and 90% bed occupancy) | |||||
Assistance with some hygiene needs by 1 member of nursing staff | 20 mins | Four | 2249 (40%) | 2398 | Yes |
Assistance with all hygiene needs or needing 2 nursing staff | 30 mins | Four | 449 (10%) | 899 | Yes |
Hours required to perform all activities | Hours required to perform activities appropriate non-registered nurses | ||||
35, 361 | 18, 534 | ||||