Indian Council of Medical Research - National Institute of Epidemiology, Chennai, Tamil Nadu Housing Board, Ayapakkam, Chennai - 600077 (
Resolve to Save Lives, New Delhi, India.
Prev Chronic Dis. 2023 May 18;20:E39. doi: 10.5888/pcd20.220232.
India is facing a shortage of staff nurses; thus, a better understanding of nurses' workloads is essential for improving and implementing noncommunicable disease (NCD) control strategies. We estimated the proportion of time spent by staff nurses on hypertension and other NCD activities in primary care facilities in 2 states in India.
We conducted a cross-sectional study in 6 purposively selected primary care facilities in Punjab and Madhya Pradesh during July through September 2021. We used a standardized stopwatch to collect data for time spent on direct hypertension activities (measuring blood pressure, counseling, recording blood pressure measurement, and other NCD-related activities), indirect hypertension activities (data management, patient follow-up calls), and non-NCD activities. We used the Mann-Whitney U test to compare the median time spent on activities between facilities using paper-based records and the Simple mobile device-based app (open-source software).
Six staff nurses were observed for 213 person-hours. Nurses spent 111 person-hours (52%; 95% CI, 45%-59%) on direct hypertension activities and 30 person-hours (14%; 95% CI, 10%-19%) on indirect hypertension activities. The time spent on blood pressure measurement (34 minutes) and documentation (35 minutes) was the maximum time on any given day. Facilities that used paper records spent more median time (39 [IQR, 26-62] minutes) for indirect hypertension activities than those using the Simple app (15 [IQR, 11-19] minutes; P < .001).
Our study found that hypertension activities required more than half of nurses' time in India's primary care facilities. Digital systems can help to reduce the time spent on indirect hypertension activities.
印度面临着护士短缺的问题；因此，了解护士的工作量对于改善和实施非传染性疾病（NCD）控制策略至关重要。我们评估了印度 2 个邦的基层医疗设施中护士在高血压和其他 NCD 活动上所花费的时间比例。
我们于 2021 年 7 月至 9 月在旁遮普邦和中央邦的 6 家有针对性选择的基层医疗设施中进行了一项横断面研究。我们使用标准化的秒表收集直接高血压活动（测量血压、咨询、记录血压测量值和其他与 NCD 相关的活动）、间接高血压活动（数据管理、患者随访电话）和非 NCD 活动所花费的时间数据。我们使用 Mann-Whitney U 检验比较了使用纸质记录和基于 Simple 移动设备的应用程序（开源软件）的设施之间活动的中位数时间。
观察了 6 名护士共 213 个人时。护士在直接高血压活动上花费了 111 个人时（52%；95%CI，45%-59%），在间接高血压活动上花费了 30 个人时（14%；95%CI，10%-19%）。在任何给定的一天中，测量血压（34 分钟）和记录（35 分钟）所花费的时间最长。使用纸质记录的设施在间接高血压活动上花费的中位数时间（39 [IQR，26-62] 分钟）多于使用 Simple 应用程序的设施（15 [IQR，11-19] 分钟；P <.001）。
我们的研究发现，高血压活动在印度的基层医疗设施中占用了护士时间的一半以上。数字系统可以帮助减少间接高血压活动所花费的时间。
