Determination of nursing manpower requirement for hemodialysis unit of a referral hospital of north India: A holistic approach

Vol. 1 No. 4

Year: 2012

Issue: Nov-Jan

Title: Determination of nursing manpower requirement for hemodialysis unit of a referral hospital of north India: A holistic approach 

Author Name: Jogindra Vati, Sunita Sharma , H S Kohli 

Synopsis: 

Safety of patients has become the matter of prime importance. Safe staffing is required in order to render the quality patient care and to cope with expanding role of nurses. Despite its importance, empirical evidence related to optimal nursing staff requirement for hemodialysis (HD) unit is lacking in Indian scenario. Hence an attempt has been made to determine nursing manpower (bedside nurses) for this unit. After getting approved from Institute ethical committee and head of department, a total 525 patients (both routine and emergency) including patients on ventilator (n=30), who underwent HD and patients for Internal Jugular vein (IJV) Catheterization (n=47) were observed for 30 days in the month of August 2009 through pretested check list developed by Delphi method of three rounds. Thus work measurement and consultative approach was used to identify the type and frequency of nursing activities required in HD unit. Total 53 nursing activities including 27 HD related, 4 ventilators related, 13 IJV related, 6 ward-related and 3 week-end related activities were identified. Maximum 93.2% of time was spent on HD related activities. On the average 648 minutes are required to carry out all activities and 28138.3 minutes per week. After calculation and keeping in mind 30% nurses for leave reserve, the data revealed that 17 bedside nurses (without meal break) are required for HD unit with 10 HD stations and one table for patients undergoing IJV catheterization. Thus this study has highlighted the need for deploying more nurses; since at present two nurses in the morning and one nurse in the evening duty are posted. It has also provided the empirical evidence for framing practice standards for nursing care of patients undergoing HD and IJV catheterization and a base for calculating nursing manpower for this specialty unit.