NURSES WORKLOAD EVALUATION - HOW AND WHY

Quality of care assessment is based on three main prerequisites : to d escribe precisely patients or case-mix, to measure the level of care, to evaluate the outcomes and finally to consider the relationships bet ween these parameters. indicators to measure the level of nurses' work load have been developped from different concepts and methodologies : The range of nurses' activities is very wide, such as cares achevied i n the presence of patient, cares achieved after medical prescription o r specific nurse cares, administrative tasks, research activities, etc . Indicators may take into account a more or less important part of th is field, but most of them are usually focused on patient's care. The Value of each parameter may be a calculated coefficient or a time unit . If one considers the time as the best unit to measure the intensity of work, it is also an underlying concept to differenciate the actual time, obtained by timing, from the required time, necessary to achieve correctly the action. In the same way, required cares are also the be st to consider. Indeed measuring required time for required cares is n ecessary to reach qualify aim. The nurses' workload may be directly ca lculated with a specific indicator or indirectly estimated from a seve rity or disability scoring system. The selection of the indicator depe nds of the purpose of the evaluation process. If the question is to im prove and develop quality of care and professionnal practices, the ind icator has to take into account the required cares. The PRN system (Pr ojet de Recherche en Nursing) developed in Canada is probably the refe rence indicator. However this score is complex and cannot be daily use d. If the question is to measure and to manage resources, the indicato r has to be as simple as possible, to be based on reproductible data c ollection and to be polyvalent. Actually, some simplified indicators h ave been elaborated from PRN system.