Balancing workload of nurses: Linear mixed effects modelling to estimate required nursing time on surgical wards

Abstract

Aim: Quantifying the relation between patient characteristics and care time and explaining differences in nursing time between wards. Design: Academic hospital in the Netherlands. Six surgical wards, capacity 15–30 beds, 2012–2014. Methods: Linear mixed effects model to study the relation between patient characteristics and care time. Estimated marginal means to estimate baseline care time and differences between wards. Results: Nine patient characteristics significantly related to care time. Most required between 18 and 35 min extra, except “two or more IV/drip/drain” (8) and “one-on-one care” (156). Care time for minimum patient profile: 44–57 min and for average patient profile: 75–88 min. Sources of variation: nurse proficiency, patients, day-to-day variation within patients. The set of characteristics is short, simple and useful for planning and comparing workload. Explained variance up to 36%. Calculating estimated means per ward has not been done before. Nurse proficiency is an important factor.