Measuring Work Demands in Hospital Nursing: A Feasibility Study

OCCUPATIONAL APPLICATIONS

This study explored the feasibility of measuring multiple work demands simultaneously in hospital nurses’ work systems. Results demonstrated that it is feasible to collect data quantifying shiftwork, organization of work, environmental stressors, physical work, mental work, and psychosocial stressors using a variety of data sources. Data collection processes were acceptable to nurse participants and the identified measures of demands were viewed as representative of nursing practice. Further, there was variability in identified measures of work demands both between and within shifts. Hospital organizations can collect these data to quantify the demands their nurses’ experience and identify opportunities for system redesign to reduce demands. In addition, future work can evaluate the relationships between identified work demand measures and nurses’ health and safety outcomes, such as fatigue, injury, and absenteeism, as well as to measures of patient safety and healthcare quality.

TECHNICAL ABSTRACT

Background: Nurses are the most prevalent healthcare professional working in hospitals. Nurses working in hospitals are exposed to numerous work hazards that pose a risk to nurses’ health, safety and performance, and in turn, pose risks to patient safety. To anticipate and potentially decrease these risks, it is necessary to better understand the multidimensional demands that hospital nurses are exposed to during work. Purpose: The aim of this feasibility study was to identify data sources within hospital systems to effectively characterize nurses’ exposure to work demands. The specific objectives were to: (1) determine the feasibility of data collection across multiple data sources; (2) describe variability within each work demand source; and (3) evaluate nurses’ acceptance of data collection methods. Methods: This descriptive, mixed methods feasibility study collected data from seven Registered Nurses working in one large academic medical center to measure work demands. Data sources included sensors on the nurse (e.g., wearable activity trackers) and in the nurse’s environment (e.g., noise), and organizational information systems (e.g., EHR, paging system). Participants were interviewed to evaluate their acceptance of data collection methods. Results: Hospital nurses are exposed to a variety of work demands. Levels of demands varied between nurses, across different times of day or periods within work shifts, and between 8- and 12-hour shifts. Nurse participants reported acceptance of the data collection methods and viewed the measures of work demands as representative of their work. Conclusions: Results of this study broaden our understanding of multiple sources of work demands in hospital nursing and demonstrate the feasibility of collecting diverse data as part of future, more robust exposure assessment systems. Achieving safe and healthy workspaces for nurses relies on the development and implementation of systems to monitor, mitigate, and manage multidimensional demands and associated risks; this study provides a critical first step.

Keywords:

• Work demands
• nursing
• healthcare
• exposure assessment

ACKNOWLEDGMENTS

The authors would like to acknowledge Brooke Eliason for her support in data analysis and manuscript preparation. We also acknowledge the Nursing Informatics department at the study hospital for support in data collection.

CONFLICT OF INTEREST

The authors have no conflicts of interest to report.

Additional information

Funding

This work was supported by a grant (AAC3695) through the University of Wisconsin – Madison Graduate School with funding from the Wisconsin Alumni Research Foundation.