Differences of weekend versus weekdays, nurse-to-patient staffing ratios, patient diagnoses, and direct nursing care time

The purpose of this study was to determine differences in time spent providing direct nursing care time on weekends versus weekdays, nurse-to-patient ratios, medical-surgical nursing units, and weekend versus weekday patient diagnoses. Specific aims were (a) determine differences in nurse-to-patient staffing ratios and direct care time on medical-surgical inpatient units in an acute care hospital, (b) determine differences in direct nursing care time on 24 hour weekend shifts versus 24 hour weekday shifts on medical-surgical inpatient units in an acute care hospital, (c) determine differences in direct care time on two medical-surgical inpatient units in an acute care hospital, and (d) determine differences of inpatient diagnoses on 24 hour weekend shifts versus 24 hour weekday shifts on medical-surgical inpatients in an acute care hospital.

A secondary analysis of a primary dataset was done using weighted least squares multiple linear regression to test three hypotheses. Chi square was done to test the fourth hypothesis. The sample consisted of a dataset that included (a) direct care time in seconds spent at the bedside, (b) unique nurse code, (c) month, (d) day, (e) shift, (f) time of day, (g) location, and (h) patient discharge diagnosis. IRB approval from Texas Woman's University was obtained for the secondary analysis of this study. Data were gathered from the Hill-Rom COMposer® electronic computer database and the medical records manager, which was subsequently imported into SPSS for secondary data analysis.

Data analysis included weighted least squares multiple linear regression for the first three hypotheses, and Chi square for the last hypothesis. Hypotheses one revealed nurse-to-patient ratio had a significant effect on direct care time (β = .24; t = 7.287, p =.000). Hypothesis two revealed weekday over weekend had the greatest effect on direct care time (β .37, t = 11.340, p = .000). Hypothesis three was not statistically significant with the least amount of effect on direct care time (β = .08, t = 2.684, p = .007). Hypothesis four showed no difference in patient diagnoses on weekend and weekdays. Weekdays and nurse-to-patient ratios effected bedside direct care time. Patient diagnoses were not different on weekend/weekdays.