Estimating neonatal nursing staff requirement by activity analysis

Abstract

Background: Nursing staff requirements for Neonatal Intensive Care Unit (NICU) are often determined by number of admitted patients even though activity analysis provides a more objective estimation. This study estimates nursing staff requirements by activity analysis in an Armed Forces facility. Materials & Methodology: A prospective observational study between 2 7 January 2014 and 26 February 2014 (31 days) in the NICU of tertiary care teaching hospital of Armed Forces where timing of all nursing activities performed during study period by NICU staff was recorded to the nearest minute by self-reporting. Nursing activities were classified as Direct (40 activities) and Indirect (23 activities) α-priori. Data was entered on an electronic spreadsheet (Microsoft Excel) and relevant analysis performed. Results: During study period, there were 32 neonates (total 238 patient-days) in NICU and 18 (57patient-days) in step-down nursery. There was no patient on invasive ventilation nor was any surgical neonate admitted during this period. Direct Nursing Care activities totaled 59499 minutes (80.4.0) and Indirect ones 14490 minutes (19.6%). All nursing activities took 44 hours per day when 24 nurse-hours per day was the available time. This worked out to a practical requirement of three nurses in each shift for such activity load. Conclusions: Based on activity analysis, this study identifies the need for three nurses in each shift for a NICU providing Level II neonatal care with an average of 8 neonates in the NICU and 2 in the step-down nursery and agrees with other such studies available in literature.

Keywords

• Neonatal Nursing
• Activity Analysis
• Nursing Staff Requirement