Alghamdi Mohammed G
Hahn School of Nursing and Health Science, University of San Diego, San Diego, CA, USA.
J Nurs Manag. 2016 May;24(4):449-57. doi: 10.1111/jonm.12354. Epub 2016 Jan 8.
The aim of the present study was to develop a comprehensive understanding of the concept 'workload' within the nursing profession in order to arrive at a clear definition of nursing workload based on the evidence in existing literature.
Nursing workload is a common term used in the health literature, but often without specification of its exact meaning. Concept clarification is needed to delineate the meaning of the term 'nursing workload'.
A concept analysis was conducted using Walker and Avant's method to clarify the defining attributes of nursing workload. As the subject matter was nursing focused, only one database was searched, the Cumulative Index for Nursing and Allied Health Literature (CINAHL). Articles that did not use 'workload' in the title or abstract were excluded. A model case, contrary case, related case and empirical referents were constructed to clarify the concept and to demonstrate how the workload is captured by the main attributes.
The attributes of nursing workload found in the literature fall into five main categories: the amount of nursing time; the level of nursing competency; the weight of direct patient care; the amount of physical exertion; and complexity of care. The attributes were organised according to the leading antecedents, which were identified as the patient, nurse and health institution.
Nurse managers need to address the workload issues with regard to the real nature of nursing work; this could increase nurses' productivity, nurses' satisfaction, turnover, work stress and provide sufficient staffing to patient care needs.
The concept analysis demonstrated clearly the complexity of the concept and its implications for practice and research. It is believed that the current concept analysis will help to provide a better understanding of nursing workload and contribute towards the standardisation of the nursing workload and the development of a valid and reliable measurement system.
本研究旨在全面理解护理行业中“工作量”这一概念,以便基于现有文献中的证据得出护理工作量的明确定义。
护理工作量是健康文献中常用的术语,但往往未明确其确切含义。需要进行概念澄清以界定“护理工作量”一词的含义。
采用沃克和阿万特的方法进行概念分析,以阐明护理工作量的定义属性。由于主题聚焦于护理,仅检索了一个数据库,即护理及相关健康文献累积索引(CINAHL)。排除标题或摘要中未使用“工作量”的文章。构建了一个模型案例、相反案例、相关案例和实证参照物,以阐明该概念并展示工作量如何由主要属性来体现。
文献中发现的护理工作量属性主要分为五大类:护理时间量;护理能力水平;直接护理患者的分量;体力消耗程度;以及护理复杂性。这些属性根据主要前提因素进行了组织,这些前提因素被确定为患者、护士和医疗机构。
护士长需要根据护理工作的实际性质来处理工作量问题;这可能会提高护士的工作效率、护士满意度、降低人员流动率、减轻工作压力,并为患者护理需求提供充足的人员配备。
概念分析清楚地展示了该概念的复杂性及其对实践和研究的影响。相信当前的概念分析将有助于更好地理解护理工作量,并有助于护理工作量的标准化以及开发有效可靠的测量系统。