Factors Affecting Nurses' Walking Distance: Age, Clinical Ladder Level, Wards, Nurse Calls, Weekend, and Patient-To-Nurse Ratio.

In many developed countries, a rapidly aging population has increased healthcare demands and the proportion of older nurses in the workforce. This demographic shift requires nursing managers to have a deeper understanding of the physical demands on staff nurses, particularly older ones. In this paper, we aim to provide valuable insights for developing evidence-based strategies to improve work environments in hospital wards. To achieve this, we conducted a statistical analysis of data on walking distance for day, long-day, and night shifts, obtained from a long-term survey across 14 wards in a large acute care hospital in Japan using automated data collection via mobile devices. Using nonparametric multiple comparisons and multiple regression analysis, we evaluated the impact of factors such as age, clinical ladder level, years of service, ward type, nurse calls, weekend, and patient-to-nurse ratio on walking distance. The multiple comparison tests revealed significant differences in walking distance among clinical ladder levels, with small to medium effect sizes. While age and years of service had some impact, their influence was less pronounced than that of clinical ladder levels. Our regression analysis showed that ward characteristics significantly affected walking distance, with emergency wards exhibiting notably longer distances. The number of nurse calls had a significant positive impact on walking distance across all shifts, while the patient-to-nurse ratio significantly affected walking distance only for night shifts. The weekend affected walking distance only for long-day shifts. These findings suggest that ward managers should reexamine the appropriate nursing care systems suited to the characteristics of their ward, and that reconsidering approaches to task assistance for less experienced nurses and night shift allocations for novice nurses could effectively reduce physical burdens on nurses. They also emphasize the importance of workload balancing in task and patient assignments and the consideration of ward characteristics in nurse reshuffling.