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PubMed · 10827626

Nursing workload: an unquantifiable entity.

M Hughes
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Abstract

BACKGROUND: In the increasingly prominent drives towards cost containment and efficiency nursing is under pressure to justify its value to healthcare. On the surface nursing workload assessment methods would appear to offer a means to quantify the nursing input to patient care. AIMS: To examine the validity of nursing workload methods with respect to nursing practice and nursing knowledge. FINDINGS: Previous studies and the conclusions of subject reviews have cast doubt on the reliability and validity of most methods and indicate that they have no clear theoretical base. CONCLUSION: It appears that nursing is more concerned with knowledge processing and nurses' intentions than just with the activities of caring. It is suggested that patients control the time element of nursing care. The need for nursing workload information, despite its validity problems, is discussed and a pragmatic solution is suggested.

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Diagnosis-Related GroupsEmpathyHumansJob DescriptionMotivationNursing Administration ResearchNursing Staff, HospitalPersonnel Staffing and SchedulingReproducibility of ResultsTime and Motion StudiesWorkloadJournal ArticleReview

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M Hughes. 1999. Nursing workload: an unquantifiable entity.. https://doi.org/10.1046/j.1365-2834.1999.00148.x

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[Measuring case severity with a DRG-based reimbursement system].

BACKGROUND: The Australian Refined Diagnosis-Related Groups (AR-DRGs) will be the model for the German DRGs (G-DRGs). Their system to measure severity of illness will be a major point of interest. METHOD: The most common systems for measuring severity of illness are presented and compared with the AR-DRGs based on criteria regarding applicability. RESULTS: None of the systems for measuring severity of illness fits all the criteria. They can be used for reimbursement of inpatient care or for quality assurance, but not for both at the same time. The designated areas for the use of the systems should not be exceeded. CONCLUSION: AR-DRGs are very complex in measuring the costs per case (severity of illness in terms of efficiency). They are not able to support quality assessment by risk adjustment (severity of illness in terms of medical complexity). A less complex system would have been easier to transfer to Germany with the same incentives for providing effective care.

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