1996 OPEN FORUM Abstracts
WORK SAMPLING: A PATIENT CARE ACTIVITY STUDY
Tracy Christopherson, R.R.T., Jerry Christopheson, R.R.T., Theresa Bergquist, B.S., R.R.T Butterworth Hospital, Grand Rapids, MI
Introduction: A work sampling study was conducted by the Respiratory care Department in the adult critical care intensive care units of a 530 bed tertiary care facility. The purpose of the study was to evaluate and measure the work done by the respiratory care practitioner (RCP) for analysts of job design and workload distribution.
Method: Activities were divided into three categories, direct care, activities performed in the presence of the patient and/or family. indirect care, activities done away from the patient but on a specific patient's behalf and personal time, personal activities not related to patient care or unit activities. Random activity samples were obtained every ten minutes during scheduled four hour observation sessions by a trained observer with a reliability rating of .50. A twenty-four hour day was used and sessions were randomly scheduled keeping it proportional for shift and weekends. sampling in this study reflects a brief moment in time so it is essential to determine a sufficient sample size. The following formula as utilized to identify the required sample size: # of units x shifts x # of activities x 40 (90% confidence) = required sample size. Data was evaluated by the survey methodologies described by Barnes, 1965; McCormick, 1979.
Activity Category %Time Per 24 Hours # of Samples
Direct Care 31%
Ventilator Management 8.47% 341
Assessment/Monitoring 5.17% 208
Procedures 10.91% 439
Transporting Patients 0.15% 6
Patient/Family Interaction 0.66% 268
Indirect Care 57%
Documentation 21.03% 847
Preparation 8.84% 356
Stat Lab Activity 6.51% 262
Communication/Information 16.97% 653
Meeting/In service 0.60% 29
Standby Time 2.53% 102
Personal Time 12% 489
CONCLUSION This baseline measurement identified for us three target areas that we could focus on: 1. Ventilator management 2. Assessment/monitoring 3. Documentation The management term was somewhat surprised by the amount of time spent in ventilator management. Within the study ventilator system checks were defined under two separate categories. One including hands on management and the other documentation. This may contributes to the small amount of time spent in this activity. Documentation seems to require the most time. Assessment and monitoring of our patients can help us individualize the care we provide to our patients, thus decreasing over utilization of services. Our study shows we certainly have room to improve in this area. Our ultimate goal is to bring the RCP closer to the patient and increase the amount of time spent in direct care. As we redesign our clinical practice and workload distribution, we will look for a corresponding increase in the amount of direct care and decrease in the amount of indirect care. This study has demonstrated that work sampling is an effective tool to measure staff time utilization for analysis of job design and workload distribution.