Workload Status at Nursing Stations in UNRWA Health Centers – Gaza Governorates

Riyad Awad Diab
رياض عوض احمد دياب
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Al-Quds University
It is needless to say that nursing is an essential component in any health system. Nurses provide critical and crucial functions in healthcare organizations, through delivering nursing care and safeguarding clients. This study aims to assess the workload status at nursing stations at UNRWA health centers in Gaza Governorates in order to contribute to the delivery of safe and effective nursing care to clients. A quantitative cross-sectional study was conducted in order to develop a workload measurement, which could serve as a management tool for decisions pertaining to staffing level. Also, the study assessed nurses’ perceptions about their workload. The instruments used in this study were self-constructed questionnaire and an extraction/observation sheet. All the nurses (163) who were working in the randomly selected 10 health centers were included in the study, out of them, 128 responded and completed self-administered questionnaires, with a response rate of 78.5%. In total, 258 nursing procedures were assessed for time unit values at the service delivery points at nursing stations in the selected health centers. The researcher collected the data by himself. General measures of reliability and validity such as standardization of methods and procedures were administered. Cronbach's Alpha reliability test was 0.903. The research findings show that there were no in use workload standards for nurses at UNRWA health centers. Nurses’ perceptions reflected relatively moderate scores regarding the overall domains constituting the entire workload status (66.75%), with the highest scores for working hours’ domain (70.25%), followed by staffing domain (66%), system domain (65.5%) and facilities domain (65.25%). Also, in response to a direct question, 91% of nurses believed that they are work overloaded and they attributed their feeling of being overloaded to factors such as increasing paperwork, inadequate staffing, increasing intensity of work, having additional non-nursing job duties and external interruptions/noise. The researcher calculated the average measurement of the time unit values per nursing procedure in minuets and it was as follows; documentation and counselling ‘3:49’; blood pressure measurement ‘0:55’, weighting baby ‘0:19’, weighting adult ‘0:18, minor dressing ‘4:37’, umbilical care ‘0:49’, doppler‘3:58’, abdominal examination ‘2:03’, immunizing a child with two injections ‘1:06’ and giving one injection in the injection room ‘1:15’. Also the time unit values consumed in minutes per client in each station were as follows; non- communicable diseases ‘3:08’, postnatal care ‘13:40’, antenatal care ‘8:58’, family planning ‘6:04’, injection ‘1:15’, health screening ‘2:49, immunization ‘3:31’ and dressing ‘4:37’. The researcher recommends reconsidering the time unit values calculated in this study to better estimating workload in UNRWA health centers. Factors affecting nurses’ workload extracted in this study need to be considered particularly facilities and system domains. Decreasing paper work, ensuring appropriate staffing level and implementing job rotation programs are important for having fair and appropriate workload.