The Table 5 shows the nursing time for each nursing domain during a day shift at medical nursing unit. Almost 24.9 minutes spend for respiration, 26.0 minutes for nutrition, (Unit, min)
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8.0 minutes for elimination, 12.7 minutes for exercise, 27.6 minutes for comfort, 2.0 minutes for hygiene, 54.4 minutes for safety, 18.2 minutes for spiritual support, 30.4 minutes for medication, 7.5 minutes for communication, and 5.3 minutes for assistance.
The Table 5 also shows the nursing time for each nursing domain during a day shift at surgical nursing unit. Almost 16.1 minutes spend for respiration, 20.6 minutes for nutrition, 15.8 minutes is for elimination, 8.2 minutes for exercise, 18.9 minutes for comport, 4.0 minutes for hygiene, 49.5 minutes for safety, 14.6 minutes for spiritual support, 21.7 minutes for medication, 5.0 minutes for communication, and 8.3 minutes for assistance.
For the day shift, the highest percentage is of safety for direct nursing activities with 54.4 minutes (25.1%) at medical and 49.5 minutes (27.1%) at surgical nursing unit. The lowest percentage is of hygiene with 2.0 minutes (0.9%) at medical and 2.9 minutes (2.2%) at surgical nursing units.
For the night shift, the highest percentage is of safety for direct nursing activities with 79.2 minutes (31.5%) by medical nurse and 68.8 minutes (28.1%) by surgical nurse.
The lowest percentage is of communication with 1.5 minutes (0.6%) by medical nurse and 0.0 minutes (0.0%) by surgical nurse.
The differences of the nursing time at the two units, based on the nursing domains by the day shift are elimination nursing, communication nursing and other’s assistance.
Almost 8.0 minutes (3.7%) and 15.8 minutes (8.7%) of nursing time is taken for elimination, 7.5 minutes (3.4%) and 5.0 minutes (2.7%) of nursing time is taken for communication and 5.3 minutes (2.4%) and 8.3 minutes (4.5%) of nursing time is taken for other’s assistance at medical and surgical nursing units respectively.
The difference of nursing time based on the nursing domains by the night shift is 25.3 minutes (11.5%) and 12.7 minutes (5.1%) for elimination nursing domain at surgical nursing unit and medical nursing unit respectively. The elimination time is higher for the surgical nursing unit than the medical nursing unit.
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Table 5The Average Nursing Time of each Direct Nursing Domain during a Shift per Nurse at Medical and Surgical Nursing Units
(Unit, min) Nursing domain Medical nursing unit Surgical nursing unit
Day shift Night shift Day shift Night shift
Time % Time % Time % Time %
Respiration 24.9 11.5 28.9 11.5 16.1 8.8 23.8 10.8
Nutrition 26.0 12.0 33.0 13.1 20.6 11.3 27.0 12.3
Elimination 8.0 3.7 12.7 5.1 15.8 8.7 25.3 11.5
Exercise 12.7 5.9 17.7 7.0 8.2 4.5 4.0 1.8
Comport 27.6 12.7 28.3 11.3 18.9 10.4 32.2 14.6
Hygiene 2.0 0.9 7.3 2.9 4.0 2.2 5.7 2.6
Safety 54.4 25.1 79.2 31.5 49.5 27.1 61.8 28.1
Spiritual support 18.2 8.4 13.9 5.5 14.6 8.0 5.0 2.3
Medication 30.4 14.0 22.5 9.0 21.7 11.9 35.7 16.2
Communication 7.5 3.5 1.5 0.6 5.0 2.7 -
-Assistance 5.3 2.4 6.2 2.5 8.3 4.5 -
-Total 217.0 100.0 251.2 100.0 182.6 100.0 220.4 100.0
Note. average time by nurse was analyzed from sample source, in which medical nursing unit (n=100), day shift (n=87), night shift (n=13); surgical nursing unit (n=101), day shift (n=95), night shift (n=6)
Generally, the average direct nursing time in both the day shift and night shift is higher at medical nursing unit than surgical nursing unit. For details, 217.0 minutes (3.62 hours) spend by the medical nurse is higher than 182.6 minutes (3.04 hours) spend by the surgical nurse for the day shift. The 251.2 minutes (4.19 hours) spend by the medical nurse is higher than 220.4 minutes (3.67 hours) spend by the surgical nurse for the night shift.
The Table 6 describes different nursing domains and the indirect nursing times spend on each nursing domain during a day shift and night shift by the medical and surgical nurse.
For day shift, the highest percentage is of recording for indirect nursing activities with 49.4 minutes (49.7%) spend by the medical nurse and 73.1 minutes (58.9%) spend by the surgical nurse. The lowest percentage is of checking with 17.7 minutes (17.8%) at
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medical and 25.9 minutes (20.9%) at surgical nursing units. The 32.2 minutes (32.5%) and 25.1 minutes (20.2%) are of equipment at medical and surgical nursing units respectively.
For night shift, the highest percentage is of recording for indirect nursing activities with 48.3 minutes (46.7%) spend by the medical nurse and 84.1 minutes (52.4%) spend by the surgical nurse. The lowest percentage is of checking with 21.2 minutes (20.5%) at medical nursing unit. The lowest percentage is of equipment management with 52.2 minutes (20.9%) at surgical nursing units. Finally, 33.9 minutes (32.8%) and 24.2 minutes (14.1%) are of equipment and environmental management at medical and surgical nursing units respectively.
Table 6
The Average Nursing Time of each Indirect Nursing Domain during a Shift per Nurse at Medical and Surgical Nursing Units
(Unit, min) Nursing
domain
Medical nursing unit Surgical nursing unit
Day shift Night shift Day shift Night shift
Time % Time % Time % Time %
Recording 49.4 49.7 48.3 46.7 73.1 58.9 84.1 52.4
Checking 17.7 17.8 21.2 20.5 25.9 20.9 52.2 32.5
Equip. check 32.2 32.5 33.9 32.8 25.1 20.2 24.2 15.1
Total 99.3 100.0 103.5 100.0 124.0 100.0 160.4 100.0
Note: average time by nurse was analyzed from sample source, in which medical nursing unit (n=100), day shift (n=87), night shift (n=13); surgical nursing unit (n=101), day shift (n=95), night shift (n=6)
In summary, the average indirect nursing time in both day shift and night shift is higher at surgical nursing unit than medical nursing unit which is opposite for the direct nursing time in the two units. For details, the 124.0 minutes (2.07 hours) spend by the surgical nurse is higher than 99.3 minutes (1.65 hours) spend by the medical nurse for the day shift. The 160.4 minutes (2.67 hours) spend by the surgical nurse is higher than 220.4 minutes (3.67 hours) spend by the medical nurse for the night shift.
According to Table 7, the analysis for this study showed that the nursing time spend for both direct and indirect nursing activities at medical and surgical is 316.3 minutes (5.27 hours) and 306.6 minutes (5.11 hours) respectively for the day shift.
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The nursing time spend by Vietnamese nurses for both direct and indirect nursing activities at medical and surgical are 354.6 minutes (5.91 hours) and 380.8 minutes (6.35 hours) respectively during the night shift.
Table 7
The Nursing Time Spend for Direct and Indirect Nursing Activities by Unit during a Shift per Nurse
(Unit, min.) Nursing time Medical nursing unit Surgical nursing unit
Day shift Night shift Day shift Night shift
Time % Time % Time % Time %
Direct 217.0 68.6 251.2 70.8 182.6 59.6 220.4 57.9
Indirect 99.3 31.4 103.5 29.2 124.0 40.4 160.4 42.1
Total 316.3 100.0 354.6 100.0 306.7 100.0 380.8 100.0
Note: average time by nurse was analyzed from sample source, in which medical nursing unit (n=100), day shift (n=87), night shift (n=13); surgical nursing unit (n=101), day shift (n=95), night shift (n=6)
In summary, the study results showed that the direct nursing time during day shift and night shift is 68.6% and 70.8% respectively at medical nursing unit, which is higher than 59.6% and 57.9% for direct nursing time at surgical nursing unit. However, the indirect nursing time at surgical nursing unit is higher than medical nursing unit for both day and night shifts. The 31.4% and 29.2% of the time spend for indirect nursing activities during a day shift and night shift respectively at medical nursing unit. The 40.4% and 42.1% of the time spend for indirect nursing activities during a day shift and night shift respectively at surgical nursing unit. The rest of the time is divided into their personal time and propagation time and these are not part of the survey for this study.
The Table 8 shows that there are significant differences in time spend for nursing domain between medical and surgical nursing unit using the Mann-Whitney test.
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Table 8Comparison of Nursing Time by Nursing Domain between Medical and Surgical Nursing Units
Nursing domain unit n Mean Rank z p
Respiration surgical 69 67.4 -2.7 0.006**
medical 87 87.3
Nutrition surgical 81 86.1 -0.7 0.493
medical 85 81.0
Elimination surgical 76 74.6 -1.6 0.100
medical 85 86.7
Exercise surgical 44 48.1 -1.3 0.202
medical 60 55.7
Comport surgical 66 69.9 -1.5 0.130
medical 85 80.7
Hygiene surgical 20 26.1 -2.3 0.019*
medical 22 17.3
Safety surgical 84 87.8 -0.4 0.681
medical 94 91.0
Spiritual support surgical 69 68.1 -1.6 0.114
medical 78 79.2
Communication surgical 61 62.3 -1.6 0.100
medical 75 73.5
Medication surgical 33 39.6 -0.1 0.899
medical 46 40.3
Assistance surgical 25 39.1 -2.6 0.011*
medical 38 27.3
Recording surgical 96 115.0 -4.1 0.000***
medical 99 81.5
Checking surgical 82 101.7 -3.4 0.001**
medical 93 75.9
Equipment
management surgical 78 79.6 -1.3 0.183
medical 91 89.6
Note:*, p<.05; **, p<.01; ***, p<.001
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The Mann-Whitney U test showed that there is a significant difference of nursing time between medical and surgical units for several nursing domains with p<.05 e.g., hygiene with z-score as negative of 2.3 value and the nursing average time at medical unit is less than surgical unit; others assisting with z-score as negative of 2.6 value and mean rank at surgical nursing unit is less than medical nursing unit.
There is a significant difference of nursing time between medical and surgical units for several nursing domains with p<.01 e.g., respiration nursing time with z-score as negative of 2.7 value and the average nursing time at medical unit is higher than surgical unit;
checking with z-score as negative of 3.4 value and the average nursing time at surgical nursing unit is higher than medical nursing unit.
There is a significant difference of nursing time between medical and surgical units for several nursing domains with p<.001 e.g., recording nursing time with z-score as negative of 4.1 value and the average nursing time at surgical nursing unit is higher than medical nursing unit.