Using national VHA data on 9,272 RNs, we show that nurses assigned more patients spend substantially more total time on medication administration, compensating with only modest per-patient time reductions.
A national, longitudinal analysis of VHA inpatient nurse staffing and medication-pass workload from 2019-2022 showing higher RN workload emerging by 2022 relative to prepandemic levels.
Measuring and assessing the relationship between inpatient nurse staffing and workload because it is challenging to systematically observe inpatient workload is difficult at the unit level in large samples. The objective of this study was to apply a novel measure of inpatient nurse workload to estimate the relationship between inpatient nurse staffing and nurse workload at the unit level during a key nursing activity, the peak-time medication pass. We found a negative relationship between the RN-to-patient ratio and average peak time medication pass duration after adjusting for unit-level patient volume and average patient severity of illness and other unit-level factors. This relationship was non-linear, the marginal effect of staffing on workload decreased as staffing increased.As unit-level nurse staffing increased, average RN workload decreased. This result suggests that interventions to improve nurse staffing may have larger non-linear effects for units with lower staffing levels.
Measuring and assessing the relationship between inpatient nurse staffing and workload because it is challenging to systematically observe inpatient workload is difficult at the unit level in large samples. The objective of this study was to apply a novel measure of inpatient nurse workload to estimate the relationship between inpatient nurse staffing and nurse workload at the unit level during a key nursing activity, the peak-time medication pass. We found a negative relationship between the RN-to-patient ratio and average peak time medication pass duration after adjusting for unit-level patient volume and average patient severity of illness and other unit-level factors. This relationship was non-linear, the marginal effect of staffing on workload decreased as staffing increased.As unit-level nurse staffing increased, average RN workload decreased. This result suggests that interventions to improve nurse staffing may have larger non-linear effects for units with lower staffing levels.