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Balancing nurses' workload in hospital wards: study protocol of developing a method to manage workload
  1. W F J M van den Oetelaar1,
  2. H F van Stel1,
  3. W van Rhenen2,3,
  4. R K Stellato1,
  5. W Grolman1
  1. 1University Medical Center Utrecht, Utrecht, The Netherlands
  2. 2Center for Human Resource Organization and Management Effectiveness, Business University Nyenrode, Breukelen, The Netherlands
  3. 3ArboNed Occupational Health Service, Utrecht, The Netherlands
  1. Correspondence to WFJM van den Oetelaar; W.f.j.m.vandenoetelaar{at}


Introduction Hospitals pursue different goals at the same time: excellent service to their patients, good quality care, operational excellence, retaining employees. This requires a good balance between patient needs and nursing staff. One way to ensure a proper fit between patient needs and nursing staff is to work with a workload management method. In our view, a nursing workload management method needs to have the following characteristics: easy to interpret; limited additional registration; applicable to different types of hospital wards; supported by nurses; covers all activities of nurses and suitable for prospective planning of nursing staff. At present, no such method is available.

Methods/analysis The research follows several steps to come to a workload management method for staff nurses. First, a list of patient characteristics relevant to care time will be composed by performing a Delphi study among staff nurses. Next, a time study of nurses’ activities will be carried out. The 2 can be combined to estimate care time per patient group and estimate the time nurses spend on non-patient-related activities. These 2 estimates can be combined and compared with available nursing resources: this gives an estimate of nurses’ workload. The research will take place in an academic hospital in the Netherlands. 6 surgical wards will be included, capacity 15–30 beds.

Ethical considerations The study protocol was submitted to the Medical Ethical Review Board of the University Medical Center (UMC) Utrecht and received a positive advice, protocol number 14-165/C.

Discussion This method will be developed in close cooperation with staff nurses and ward management. The strong involvement of the end users will contribute to a broader support of the results. The method we will develop may also be useful for planning purposes; this is a strong advantage compared with existing methods, which tend to focus on retrospective analysis.

  • workload management
  • staff planning
  • nurse workload

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  • Contributors WFJMvdO is the corresponding author and guarantor. WFJMvdO and WG conceived the study. WFJMvdO, WG, WR, RKS and HFvS participated in its design. WFJMvdO gathered and cleaned the data, coordinated the study and drafted this manuscript. RKS performed statistical analysis. HFvS helped to draft the manuscript. All authors revised the manuscript drafts and approved the final manuscript.

  • Funding This study is entirely funded by the University Medical Center (UMC) Utrecht.

  • Competing interests None declared.

  • Ethics approval The study protocol was submitted to the medical ethical review board of UMC Utrecht and received a positive advice, protocol number 14-165/C.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The statistical code and data set are available from the corresponding author.