Identification of the virtual workload of Advanced Practice Nurses in the delivery of direct patient care: A Time and Motion study

Background: Advanced Practice Nurses in Ireland include Clinical Nurse Specialists and Advanced Nurse Practitioners. They are nurses who work independently providing care to both acute and chronic patients using advanced knowledge and critical thinking skills gained through education and experience. Advanced nursing work spans multiple domains. Aim: To identify the proportion of Advanced Practice Nurses’ workload that takes place virtually in the delivery of direct patient care. Methodology: A observational study was conducted for this research. Method: An overt non participatory time and motion study was undertaken using a predefined data collection tool to identify the activities of the study participants, and the mode used for delivery of the activities identified. Findings: Twenty two percent of Advanced Practice Nurses’ time was spent delivering direct patient care virtually. The primary mode of telecommunication technologies used in this research were landline telephones and desktop computers. The most frequently performed direct patient care activity was gathering and interpreting assessment data to formulate a plan of care. Discussion: This is the first research to calculate the proportion of Advanced Practice Nurses’ time that is spent delivering direct patient care virtually. The findings indicate that a significant proportion of Advanced Practice Nurses’ time is spent delivering virtual care. Conclusion: The study has identified that a substantial proportion of Advanced Practice Nurses’ time is spent delivering direct patient care virtually.
Implications: A significant volume of work is conducted virtually. It should be conducted in a secure environment using secure devices. The nurses conducting virtual direct patient care ought to be adequately resourced with appropriate technology. Education for nurses conducting virtual work should be provided from the outset.