The administrative tasks burden in inpatient units: an observational study to quantify the impact on nursing staff's working time.

Background Administrative tasks (ATs) are perceived by healthcare workers as something that takes up an inappropriate number of nurses' working time and limits their ability to provide an adequate amount of 'direct care' to their patients. Understanding the kind of ATs mistakenly attributed in this period of staff shortage can be significant in the analysis of the congruence between the nurse's skills and the work/organizational process. In the inpatient units there are some ATs performed by nurses, such as organizing documentation and forms, answering phone calls, planning visits and appointments that, could probably be performed by administrative staff. However, other ATs, such as keeping medical records and management of requests, the input of clinical data into specific administrative applications (e.g. hospital administrative admission/discharge), the care planning to support the 'patient's journey', which even if perceived as ATs, can be identified as 'indirect assistance', not visible to the patient, but closely related to the patient's journey. The aim of this study was to identify the ATs that occupy the RNs working time in acute hospital units and the frequency with which these activities are carried out. Materials and Methods A real-time repeated measure design conducted between November and December 2024, involving inpatient medical, surgical, geriatric and intensive care units. The data collection took place, via a chart in the form of a grid that recorded the ATs, the profile of the workers who carried them out, the weekly time spent in minutes and the frequency with which this activity was carried out. The data analysis looked at all the aforementioned elements', the identification of the healthcare working time spent weekly and the frequency these activities being conducted. Results The ATs carried out in inpatient units can be divided into four categories: administrative activities connected with medical records; the management of laboratory and diagnostic tests; the management of waiting lists; and those linked to 'the good functioning' of the unit. 'On average, in medical departments, the record management takes up 23.58 hours of RNs' working time per day; 17.35 hours in the surgical departments; 4.44 hours in the geriatric wards and in the intensive care units 3.29 hours. Every day, the diagnostic and laboratory tests occupy, on average, 29.49 hours of RN working time in the medical departments, 15.45 hours in the surgical units, 3.45 hours in the intensive care units, although it does not seem to absorb RN working time in the geriatric's wards. The waiting list management seems not to occupy any RN working time, except in the surgical departments, which has an average of 2.48 hours per day, while they occupy 3.56 hours of the administrative staff's (AS) working time in the medical units, 3.21 hours in the surgical area and 51 minutes in the intensive care units. Those ATs associated with the good functioning unit that take up most nurse managers' (NMs) working time are as follow: 29.49 hours in the medical area; 21.51 hours in the surgical departments; and 9.01 hours in the geriatric's units. Conclusions The study increases the knowledge of ATs performed by RNs in inpatient units, and provides ideas of the organizational interventions that could be implemented, which would also help to improve nurses' retention, through the co-design and review of their working processes. Future studies should include the testing these interventions to reduce nurses' working time that is currently dedicated to performing certain inappropriate ATs and to understand if establish whether increases in direct care working time, reduce the missed nursing care phenomenon and it improves the organizational, staff and patient outcomes.