6 ways to optimize nurse workload

A Mckinsey analysis found ways to save 15 to 30 percent of a nurse's 12-hour shift by rearranging their workload through technology and delegation.

McKinsey, in collaboration with ANA Enterprise, surveyed 310 registered nurses from Feb. 8 to March 22 on the average time spent during a typical shift on 69 activities and then asked the ideal amount of time they wish they spent on those activities.

They found six activities that could be adjusted to free up nurses' time and allow them to spend more time on the things they enjoy.

Here are seven findings:

  • Nurses report spending 54 percent, or seven hours, of a shift on direct patient care and creating personal connections with patients. Nurses reported they wanted to spend even more time on these activities.

  • Nurses spend about 2 percent of their shift teaching peers and students, and they indicated they wanted to double the time spent on peer-to-peer coaching.

  • Nurses wanted to spend about 7 percent of their time on growth and development activities such as shared governance, reviewing and reading work emails, and completing annual requirements or continuing education hours.

  • Documentation took up about 15 percent of the nurses' shifts, and ideally, nurses wanted it to make up only 13 percent. Of documentation tasks, 70 percent were head-to-toe assessments, admissions intakes and vitals charting.

  • Nurses reported spending 6 percent of their shift on "hunting and gathering" tasks such as searching for individuals, equipment, supplies, medications or information. They wanted time spent on these tasks cut in half.

  • Nurses said they spend nearly 5 percent of their shift on tasks that do not use the fullest extent of their license or training, such as nutrition and daily living activities.

  • Thirty-seven percent of nurses report not having access to vital signs or telemetry machines that are integrated with electronic medical records for automatic documentation.

The authors estimate that freeing up 15 percent of nurses' net time could translate to closing the nursing workforce gap by up to 300,000 inpatient nurses. Hospitals can use full or partial delegation of activities to reduce net nurse time by 5 to 10 percent during 12-hour shifts on many of these tasks. Tasks such as patient ambulation, drawing labs, transferring patients and supporting patient procedures could be delegated to appropriate support professionals and free up nearly an hour of nurse time.

The report found 10 to 20 percent of time could be optimized through technology by automating tasks. Ensuring technology itself does not create redundancies, delays or increase workload is important when implementing new technologies.

"Realizing these changes will require bold departures from healthcare organizations' current state of processes. It will be critical for hospitals to bring both discipline and creativity to redesigning care delivery in order to effectively scale change and see meaningful time savings," the report said.

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