J Korean Acad Nurs Adm.  2011 Sep;17(3):315-326.

Study on Non-Value-Added Nursing Activities in a Tertiary Hospital

• Kim MY
• Park SA

Abstract

PURPOSE
Purposes of this study were to identify non-value-added nursing activities (NVANAs) and to estimate the amount of time spent on NVANAs among total nursing activities.
METHODS
Non-value-added nursing activities were identified though the use of a focus group. The nurses in the focus group were nurses working in a tertiary hospital. They discussed possible activities that could be NVANAs. Based on the focus group discussion, a pilot study was done to examine the actual occurrence of NVANAs in clinical settings.
RESULTS
The focus group discussion showed that NVANAs occurred in ten categories of nursing performances including communication with physicians, communication with other departments, medications, equipment/supplies, nursing records, tests, admission, discharge, and transfer. Direct nursing activities accounted for 35.5% of total nursing activities while indirect nursing activities accounted for 64.5%. Of indirect nursing activities, 16% were NVANAs. Most NVANAs were related to communication and equipment/supplies.
CONCLUSIONS
To improve the quality and efficiency of nursing activities, it is necessary to identify NVANAs and their causes. Results of this study suggest that improvement in the work process and nursing unit structure, support for equipment/supplies, and effective communication are needed to reduce NVANAs in tertiary hospitals in Korea.

Keyword

Non-value-added nursing activity; Nursing time; Focus group

MeSH Terms

Focus Groups
Korea
Nursing Records
Pilot Projects
Tertiary Care Centers

Reference

1. Capuano T, Bokovoy J, Halkins D, Hitchings K. Work flow analysis: eliminating non-value-added work. J Nurs Adm. 2004. 34(5):246–256.

2. Chi SA, Lee EH, Cho KS, Suh MJ, Kang HS, Lim NY, et al. A study for establishment of clinical nurse's role in Korea. Clin Nurs Res. 2003. 9(2):107–123.

3. Hendrich A, Chow M, Skierczynski B, Lu Z. A 36-Hospital time and motion study: how do medical-surgical nurses spend their time? Perm J. 2008. 12(3):25–34.

4. Kim E, Lee H. Legal definition of nursing practice. J Korean Acad Nurs Adm. 2006. 12(4):574–586.

5. Kim HL. A comparison of nursing activity before and after implementation of OCS in general hospital. 2004. Pusan: Inje University of Korea;Unpublished master's thesis.

6. Lee MS, Choi KS, Son HM, Eun Y. Understanding nursing practice through qualitative research. 2005. Seoul: Koonja.

7. Lee TW, Kim CJ, Park JS, Kim SS. Nurse's adoption on a planned organizational change. J Korean Acad Nurs. 2002. 32(2):155–164.

8. Park JH, Song M, Sung YH, Cho JS, Sim WH. Estimation of nursing costs for hospitalized patients using the resource-based relative value scale. J Korean Acad Nurs Adm. 1999. 5(2):253–280.

9. Park JH, Sung YH, Song MS, Cho JS, Sim WH. The classification of standard nursing activities in Korea. J Korean Acad Nurs. 2000. 30(6):1411–1426.

10. Park JH, Sung YH, Park KO, Kim YM, Nam HK, Kim KS. Measurement and analysis of the standard nursing practice times of the reference nursing activities. Clin Nurs Res. 2006. 12(2):17–29.

11. Park SA, Jeong MS, Kim JH, Kim JK, Joo MK, Park SH, Yu M. Nursing management & policy. 2010. Seoul: Koonja.

12. Shin HC. Innovation of management accounting. 1993. Seoul: Kyungmoonsa.

13. Song YS. Estimation of optimum hospital nursing manpower by patient classification system. 1983. Seoul: Ewha Womans University of Korea;Unpublished master's thesis.

14. Storfjell JL, Ohlson S, Omoike O. The balancing act: patient care time versus cost. J Nurs Adm. 2008. 38(5):244–249.

15. Storfjell JL, Ohlson S, Omoike O, Fitzpatrick T, Wetasin K. Non-value-added time: the million dollar nursing opportunity. J Nurs Adm. 2009. 39(1):38–45.

16. Upenieks VV, Akhavan J, Kotlerman J. Value-added care: a new way of assessing nursing staffing ratios and workload validity. J Nurs Adm. 2007. 37(5):243–252.

17. Upenieks VV, Akhavan J, Kotlerman J. Value-added care: a paradigm shift in patient care delivery. Nurs Econ. 2008. 26(5):294–300. quiz 301.