JMIR Publications

ABSTRACT

Background:

Understanding current nursing workflows is essential to informing future workforce redesign strategies, including virtual nursing roles. However, granular insights into current nursing workflows over a 24-hour period and across different staff grades, are lacking.

Objective:

1. Quantify how registered and enrolled nurses in the general acute medicine wards distribute their time across direct and indirect care tasks over a 24-hour period 2. Identify multitasking burdens and temporal distributions 3. Identify opportunities for development of a virtual nursing role

Methods:

Using time-and-motion methodology, we observed, registered nurses and enrolled in three general medicine wards over a 24-hour period between April and June 2024. We observed three task categories (Admin, Communication, and Bedside tasks), with multiple individual tasks monitored under each category. Mutli-tasking (i.e. the occurrence of two or more tasks occurring concurrently) was also tracked. The checklist was piloted and refined before data collection.

Results:

We observed a total of 48 nursing shifts. During the daytime, registered nurses spent 70% of their time on indirect care tasks, compared with 54% for enrolled nurses. At night, the proportion of time on indirect care tasks decreased to 58% for registered nurses and 39% for enrolled nurses. During a 24-hour period, a registered nurse spends 326 minutes multitasking (209 mins in the daytime), while an enrolled nurse spends 262 minutes multitasking (152 minutes in the day).

Conclusions:

These findings highlight opportunities for virtual nursing roles, which if thoughtfully designed, may help redistribute indirect care tasks, reduce multitasking burden, and enhance overall efficiency without compromising care quality. Clinical Trial: NA