This study examined nursing care in a Newborn Intensive Care Unit (NICU) by reviewing nursing activities for the newborns. Through direct observation, time used for nursing care according tothe nursing activity, shift. day of the week. and position of the nutses was measured.
This study was done on November 15, 21. 24. 1999 at a university medical center hospital and included eight nurses and 179 newborns as the study subiects. The data were collected from the medical tecords, and by using a nursing activity record for the NICU, and a nursing activity time record for the NICU.
The first step in the data collection p-ocess was to develop a list of nursing activities which was done through a literature review, examination ~~f medical affairs and duty records. Content vali-~~ity was measured by a panel of three professors ~vho were experienced clinicians. In the second step two pre-training sessions were held with three sophomore student nurses who then measured the time for each nursing activity using a stopwatch. The data wete analyzed using fiequencies for nursing activities, averages, percentages and ANOVA for differences between shift and between days of the week. and percentages and t-test for differences according to position of the nurse. Tl7e results are as follows
1) The total number of activities was 156. direct or indirect nursing activities. Direct nursing activity classified according to physical. educational, emotional/social/economic/spiritual needs. There were 109 direct nursing activities in 16 fields.
2) The order of nursing activities. according to time required, was record keeping, nutritional care. measurement/observation. medication, hygiene care, examination and specimen collection. and checking supplies, and according to frequency. measurement/ examination, iecotd keeping. nutrition care. hygiene care. elimination care and medication.
3) According to shift, direct care during the night shift at 313.4 minutes was the longest time and indirect nursing care during the night shift at 252.2 minutes was the highest time.
4) For days of the week Monday had the highest time foi direct care 275.8 minutes (34.6%) and ~~%ednessday had the highest time for indirect nursing care 269.6 minutes (36.1%).
5) For nursing time according to position of nurse. general nurses had the highest for direct care (330.7 minutes), nurse managers for indirect nursing activities (239.0 minutes) and general nurses foi individual private time (63.9 minutes).
The results of this study show that the major nursing time consuming activities included record keeping, nutrition care and measurement/examinatiori. For newborns, time needs to be allowed for care to be sensitive, sophisticated and specialized ;rather than concentrated on indirect nursing tasks such as record keeping. Therefore. it is imperative to develop computerized systems that support a systematic approach to record keeping which is more efficient. IVloreover. nursing needs according to shift, day or position of nurse can be utilized in assessing nursing resources through a computerized process.
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