Nurses' use of time in a medical-surgical ward with all-RN staffing

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Abstract
To investigate allocation of nursing time, organisation of nursing activities and whether or not allocation and organisation have changed over time.In a ward that changed to all-RN staffing, the nurses were encouraged to implement a patient-focused philosophy. The nurses perceived that they had difficulty in using the time available efficiently.Non-participant observations were conducted with 2-year intervals. Ten consecutive weekdays were covered on two occasions. The study was carried out at a university hospital in Sweden.Between observations, a significant change in the organization of the direct care had occurred, and the same tendency was found in patient administration and general management. The organization of work changed from a partly fragmented to a more coherent one. The time used for direct care and administrative activities increased between the two observations, while indirect care, personal and service activities decreased.It can be suggested that the nurses used their time efficiently and, over time, they developed a more coherent way of organizing nursing activities.

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