Dimensioning of nursing staff in outpatient chemotherapy: application of the Workload Indicators of Staffing Need

Santos, Daniela Vivas dos; Gaidzinski, Raquel Rapone

doi:10.1590/S1980-220X2018003803456

Acessibilidade / Reportar erro

Brasil

Revista da Escola de Enfermagem da USP

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLE • Rev. esc. enferm. USP 53 • 2019 • https://doi.org/10.1590/S1980-220X2018003803456 copy

Dimensioning of nursing staff in outpatient chemotherapy: application of the Workload Indicators of Staffing Need^* * Extracted from the thesis: “Dimensionamento de profissionais de enfermagem para assistência oncológica ambulatorial: aplicação do método WISN”, Universidade de São Paulo, 2018.

Dimensionamiento de profesionales enfermeros en quimioterapia ambulatoria: aplicación del método Workload Indicators of Staffing Need

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To apply the method developed by the World Health Organization, called Workload Indicators of Staffing Need for dimensioning the nursing staff for the care of cancer patients in a Chemotherapy outpatient clinic.

Method:

This is a quantitative, observational, documentary field study with an intentional sample. Prospective data were collected through the work sampling method.

Results:

Seventeen nurses and 12 nursing technicians participated in the study. A total of 3,727 observations were performed and were obtained the mean times and the relative working time of 23 nurses’ interventions and 18 nursing technicians’ interventions. The interventions corresponded to 88.5% of the relative working time of nurses and 83.9% of nursing technicians. Personal activities accounted for 8.2% of the relative working time of nurses and 7.9% of nursing technicians. The reliability test resulted in 86.3% concordance.

Conclusion:

The similarity between the staff required according to the method studied and the current staff showed that the Workload Indicators of Staffing Need has great potential and applicability for dimensioning nursing professionals safely.

DESCRIPTORS:
Oncology Nursing; Nursing Staff; Workload; Ambulatory Care

NIC code	Name of interventions	Nurse			Nursing Technician
NIC code	Name of interventions	N. Interventions	Relative working time%	Mean time (minutes)	N. Interventions	Relative working time %	Mean time (minutes)
2300	Medication Administration	83	4.5	6.7	616	46.5	7.2
2240	CT Management (CT administration)	526	27.3	6.4	-	-	-
7910	Consultation	234	20.0	10.5	-	-	-
6480	Environmental Management	68	3.0	-	206	11.6	-
3660	Wound Care	9	0.9	10.3	-	-	-
7660	Emergency Cart Checking	4	0.2	5.4	-	-	-
7920	Documentation	347	16.1	-	118	7.0	-
5618	Teaching: Procedure/Treatment	57	2.8	6.0	31	2.0	6.2
7690	Laboratory Data Interpretation	12	0.5	-	-	-	-
4054	Central Venous Access Device Management	31	2.7	10.9	-	-	-
6680	Vital Signs Monitoring	23	1.1	5.8	190	12.8	6.5
8140	Shift Report	49	2.2	-	43	2.4	-
7722	Preceptor: Employee	38	1.7	-	10	0.6	-
6574	Risk Identification (CT prescription analysis)	33	1.6	6.1	-	-	-
7850	Employee Development	30	1.3	-	12	0.7	-
0840	Positioning	32	1.4	5.4	27	1.5	5.4
7960	Health Care Information Exchange	215	9.6	-	63	3.6	-
6540	Infection Control	28	1.2	-	122	6.9	-
7160	Presence	17	0.8	5.4	12	0.7	5.4
	Administrative Meeting	10	0.7	8.7	2	0.2	8.1
6574	Risk Identification (CT double checking)	-	-	-	25	1.4	-
7680	Examination Assistance	-	-	-	2	0.1	6.3
4190	Intravenous (IV) Insertion	-	-	-	15	1.6	10.0
1870	Tube Care	1	0.1	5.8	5	0.4	7.6
6574	Risk Identification (patient identification)	3	0.2	7.3	2	0.1	5.4
8180	Telephone Consultation	2	0.1	8.2	-	-	-
	Total	1,852	100.0		1.501	100.0

DIMENSIONING OF NURSING STAFF: ONCOLOGY AMBULATORY
Item	Origin of parameters	Chemotherapy	Professional:	Nurse	Professional category nurse
Item	Available Work Time (AWT)				Professional category nurse
TTD	Available work time (hours per year/professional)				1688
Item	Recorded interventions	Annual production of intervention (p)	Mean time of interventions of the nurse (T) hours		Required quantity of nurse Q (p x t)/ttd
1	Consultation	54838	0.17		5.52
2	CT management (CT administration)	90475	0.10		5.36
3	Risk identification (CT prescription)	31061	0.10		1.84
A	Total required in category: nurse for service interventions				12.72
Item	Suport interventions				Percentage participation of nurse
	Teaching: Procedure and Treatment / Infection Control / Vital Signs and Antropometrics Monitoring / Medication Administration / Documentation / Laboratory Data Interpretation / Positioning / Presence / Shift Report / Tube Care / Wound Care / Administrative Meting / Environmental Management / Health Care Information Exchange / Central Venous Access Device Management / Risk identification (patient identification) / Emergency Cart Checking / Telephone Consultation / Preceptor: Employee				49.45
S%	Sum of percentage of category allowance in support services				49.45
B	Category allowance factor: {1/[1(s%/100)]}				1.98
I	Allowances standard (hours/year)
1	Interconsulta (Specialty: chemotherapy)				2704.00
2	Teaching: group (Conte com a gente)				260.00
	Sum of hours used in additional interventions				2964.00
C	Individual allowance factor = i/awt				1.76
Q	Total required in a category: Nurse q=(a . B) + c				27

DIMENSIONING OF NURSING STAFF: ONCOLOGY AMBULATORY
Item	Origin of parameters	Chemotherapy	Professional:	Technician	Professional category technician
Item	Available Working Time (AWT)				Professional category technician
TTD	Available working time (hours per year/professional)				1576
Item	Recorded interventions	Annual production of intervention (p)	Mean time of interventions of the Technician (T) hours		Required quantity of technician Q (p x t)/ttd
1	Medical Administration	104566	0.12		7.96
2	Vital Signs	103402	0.10		6.56
4	Risk identification (Double checking CT)	90475	0.09		5.17
A	Total required in category: Technician for record interventions				19.69
Item	Suport interventions				Percentage participation of technician
	Teaching: Procedure / Treatment / Infection Control / Documentation / Positioning / Presence / Shift Report / Tube Care / Administrative Meeting / Environmental Control / Health Care Information / Risk Identification (patient identification) Intravenous Insertion / Preceptor: Employee / Examination Assistance				38.66
S%	Sum of percentage of category allowance in support services				38.66
B	Category allowance factor: {1/[1(s%/100)]}				1.63
I	Allowances standard (hours/year)
	Sum of hours used in additional interventions				0.00
C	Individual allowance factor = A/AWT				0.00
Q	Total required in a category: technician Q=(A . B) + C				32

Category	ICESP existing professionals*	WISN staff	Difference	Problem in workload	Ratio	Pressure
Nurse	25	27	-2	Insufficient	0.9	Low
Technician	31	32	-1	Insufficient	1.0	Normal

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding author: Daniela Vivas dos Santos Rua Angaí, 27, Vila Brasilândia CEP 02844-100 - São Paulo, SP, Brazil danielavivas@yahoo.com.br