The examination of nursing work through a role accountability framework

J Nurs Manag. 2015 Jul;23(5):604-12. doi: 10.1111/jonm.12186. Epub 2013 Nov 27.

Abstract

Aim: To use work analysis data to describe the amount of time registered nurses (RNs) and health care aides (HCA) spent on key clinical role accountabilities and other work activities.

Background: Health care providers are not effectively utilized. To improve their efficiency and effectiveness, it is necessary to understand how nursing providers enact their role accountabilities.

Method: Using palm pilot Function Analysis technology, observers recorded the activities of 35 registered nurse and 17 health care aides shifts on a second-by-second basis over 5 days. Work activities were classified using the Nursing Role Effectiveness Model, which conceptualizes nursing practice in terms of clinical role accountabilities.

Result: The registered nurses spent a considerable amount of time on bio-medical assessment/surveillance, relatively little time was spent on patient and family psycho-social-cultural-spiritual assessment/surveillance and support.

Conclusion: Unlike other work sampling studies, this research project examined nursing work within a role accountability framework; an important first step in the call for the measurement of the impact of nursing care.

Implications for nursing management: Changes to how registered nurses and health care aides enact their role will require a clear vision by unit managers and their staff of their role accountabilities, and the gap between ideal and actual practice.

Keywords: health care aides; nursing; role accountability; work activities; work sampling.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alberta
  • Humans
  • Models, Nursing
  • Nurse's Role*
  • Nursing Staff, Hospital / psychology*
  • Social Responsibility*
  • Task Performance and Analysis
  • Workplace*