Concept Analysis in Nursing

Concept Analysis in Nursing

Introduction

Prompted in part by the needs of health system funders and administrators to understand and manage the cost of nursing services, the measurement of nursing workload has been the focus of considerable interest and research since the late 1950s and early 1960s. For many years, interest in nursing workload measurement was widely confined to hospital settings. This focus on the hospital setting is not surprising given that by the middle of the twentieth century most health care was provided in hospitals. Moreover, in-patient nursing is the single largest expenditure in hospitals, accounting for approximately 30% of hospital budgets. However, beginning in the late 1980s, home care services have been increasingly recognized as an important component of the health care system in USA, Canada, and in many other countries. Therefore, all the issues related to concept analysis in nursing will be discussed in detail.

Aims and Purposes of the Analysis

Nursing workload has been defined generically as the amount of performance required to carry out nursing activities in a specified time period. This definition neither acknowledges differences in the complexity, knowledge or skill requirements for the diversity of nursing activities, nor recognizes the vastly different circumstances and needs of patients which influence nursing workload. A definition for home care nursing workload was not found in the literature. Moreover, the perspectives of home care nurses, administrators or other stakeholders regarding the characteristics of contemporary home care nursing workload are not well documented. No evidence was found that the concept of home care nursing workload has ever been formally analyzed; however related concepts have been analyzed. These concepts included nursing productivity, nursing care, home visiting and nursing workload from a generic perspective. The absence of literature and empirical findings related to home care nursing workload supports this study's systematic examination of the concept, particularly in light of a growing body of evidence regarding the importance of nursing workload to patients, nurses, employers and the health care system (Byrd, 1995, 89).

Synergy

Workload in nursing is important for several reasons. Firstly, workload levels have been shown to influence outcomes such as mortality and morbidity for hospital patients and the amount of time the home care nurse spends in the patient's home. Secondly, workload levels have been shown to influence the job retention and job satisfaction of nurses who work in the hospital setting and in home care setting. Accordingly, measuring and managing nursing workload has the potential to optimize outcomes for nurses, patients and employers. Home care nursing is unique. It has been named as a specialty nursing practice and requires specific clinical care nursing competencies not utilized by hospital nurses. A reasonable workload is important to home care nurses and was one of the factors found to influence home care nurse job retention. Workload levels are associated with quality of work life in both the hospital and home care sectors. Consequently, measuring home care nursing workload and addressing excessive workload levels has the potential to support nurse retention ...