[How nurses spend their time-shift and the strategies adopted to maximize it: a scoping review]

Abstract

. How nurses spend their time-shift and the strategies adopted to maximize it: a scoping review.

Introduction: Investigating how nurses spend their time during the shifts has become important mainly recently, due to the nursing shortage.

Aim: The aims of the study were to map and summarise, (a) how nurses use their time-shift in different care settings, and (b) the time-shift management strategies implemented.

Method: A scoping review according to the Arksey and O'Malley framework, integrated by Levac and colleagues and the Preferred Reporting Items for Systematic review and Meta-analysis extension-Scoping reviews guideline was conducted in 2021.

Results: Thirty-one studies were included (30 primary studies, one secondary), published from 1987 to 2021, mainly conducted in USA, UK and Sweden. Most of them were based on quantitative designs (23/30). In critical and psychiatric settings, the nursing time is dedicated almost equally in direct and indirect care; in the medical, surgical, and oncological units, the direct care activities occupy around the 30% of the nursing time-shift, whereas the indirect care activities increase. In long-term settings the indirect care reaches the 60% of nursing time while in home care around one third of time is spent in direct care. Nurses enact different time-management strategies during the shift.

Conclusion: Nurses spend limited time at the bedside, as perceived also in the Italian nursing practice; making more visible to patients and their caregivers the value of the indirect care performed by nurses is necessary.