Observing how RNs use clinical time in a nursing home: a pilot study.

Dellefield ME, Harrington C, Kelly A. Observing how RNs use clinical time in a nursing home: a pilot study. Geriatric nursing (New York, N.Y.). 2012 Jul 1; 33(4):256-63.

Related HSR&D Project(s)

• CDA 06-015 – Guideline Implementation in Nursing Homes: Targeted Supervisory Feedback
• NRI 05-146 – Improving Quality: Registered Nurse Work Activities in VA Sponsored Nursing Homes

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Abstract:

Registered nurses (RNs) working in nursing homes (NHs) are a scarce professional resource. Their responsibilities include direct (e.g., assessment, physical care, and medication administration) and indirect care (e.g., documentation, supervision, and other activities performed away from the resident to manage their care environment). The purpose of the study was to describe the direct and indirect care distribution of RNs working day shift in an NH. All RN care was observed, although RN care associated with pressure ulcer prevention as a clinical outcome was highlighted. Work sampling was conducted using a personal data assistant-based RN Observation Measure. RNs spent 59% of their time on indirect care. Little direct care could be linked with specific clinical categories relevant to pressure ulcer prevention. RNs are challenged to use RN clinical time more strategically.