Elsevier

Nursing Outlook

Volume 64, Issue 3, May–June 2016, Pages 244-254
Nursing Outlook

Article
Practice
Nursing workload in the acute-care setting: A concept analysis of nursing workload

https://doi.org/10.1016/j.outlook.2016.01.003Get rights and content

Abstract

Background

A pressing need in the field of nursing is the identification of optimal staffing levels to ensure patient safety. Effective staffing requires comprehensive measurement of nursing workload to determine staffing needs. Issues surrounding nursing workload are complex, and the volume of workload is growing; however, many workload systems do not consider the numerous workload factors that impact nursing today.

Purpose

The purpose of this concept analysis was to better understand and define nursing workload as it relates to the acute-care setting.

Methods

Rogers' evolutionary method was used for this literature-based concept analysis.

Discussion

Nursing workload is influenced by more than patient care. The proposed definition of nursing workload may help leaders identify workload that is unnoticed and unmeasured.

Conclusion

These findings could help leaders consider and identify workload that is unnecessary, redundant, or more appropriate for assignment to other members of the health care team.

Section snippets

Method

Rogers' Evolutionary Method was used for this literature-based concept analysis to assess nursing workload in acute-care hospital settings. The steps included in this method are (a) identifying the concept and its synonyms, (b) selecting a setting, (c) collecting information, (d) analyzing the findings, (e) examining an exemplar, and (f) discussing implications of the concept in nursing. The evolutionary method is useful for this concept analysis because of the dynamic nature of workload, the

Identifying the Concept

Rogers' method encourages recognition of how concepts evolve over time, and therefore we begin with a brief discussion of the history of this concept (Rogers & Knafl, 2000). The term “workload” began emerging as a concept of study in the late 1930s when the Fair Labor Standards Act was implemented. These laws limited the length of the work week, increased minimum wage, and ended child labor. Because of these changes, supervisors needed to know how much idle time the workers had to maximize the

Definitions and Synonyms in Nursing

Definitions of nursing workload often discuss the amount of time it takes to complete tasks that must be carried out during a given time (Morris et al., 2007, Myny et al., 2011). Myny et al. (2011) best captured the definition of nursing workload presented by Needham (1997) as “the time taken to carry out ‘direct’ and ‘indirect’ care as well as other activities, including ward and organization management” (p. 2110); this definition considers that the concept is comprised of more factors than

Discussion

The goal of this concept analysis was to examine workload in an acute-care setting using Rogers' evolutionary method. The findings were analyzed by identifying the concept in both a historical and a nursing-specific context. The analysis of workload within the acute-care hospital setting was presented in four steps which illustrate the complex nature of workload in the acute-care setting by highlighting the variation in workload definitions and measurement. In addition, the way nurses spend

Acknowledgments

The authors would like to acknowledge the School of Nursing, University of Alabama at Birmingham, for insight and continued support throughout article development.

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