A Labor and Delivery Patient Classification System Based on Direct Nursing Care Time
Final rept. Feb 1988-Jul 1991
ARMY HEALTH CARE STUDIES AND CLINICAL INVESTIGATION ACTIVITY FORT SAM HOUSTON TX
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This study was conducted as directed by the Army Medical Department AMEDD Study Board to extend the Workload Management System for Nursing WMSN into Labor and Delivery L and D. The focus of the study was on nursing time spent in direct care, or that time spent performing nursing activities at the patients bedside. By evaluating direct care time, a patient classification instrument was developed based on patient acuity. Subsequent to the AMEDD Study Board tasking, the Joint Manpower Office of the Office of the Assistant Secretary of Defense Health Affairs OASDHA determined that this study would be used in developing the triservice manpower staffing standard for L and D. The study was comprised of three phases, each of which involved collecting data at various Army hospitals for analysis. In Phase I, mean times were derived for each task relevant to L and D. In Phase II, a worksheet was constructed to reflect the relevant L and D tasks. Once the validity and reliability of the instrumentworksheet were established, data were collected and analyzed to establish the acuity categories, and derive a subset of predictors that would reflect total direct care time. Phase III consisted of three parts. First, a panel of clinical nursing experts formatted the worksheet and evaluated user instructions. Second, instrument validity and reliability were verified using the smaller set of direct care indicators. Finally, L and D nursing staff members used the revised worksheets for two weeks, and provided a critique of the worksheets.... Nursing, Patient classification, Labor and delivery.
- Personnel Management and Labor Relations