Key Flow Processes on Wards.

OBJECTIVE: The aim of the study is to test a new nurse movement route analysis (NMRA) method for measuring nurses' traffic volume between rooms on wards. BACKGROUND: The World Health Organization calls for urgent investment in nurses. On the other hand, the challenges in the availability, direct care activity, and staffing of registered nurses make increasing the quality of care by process improvement a central objective for nursing. METHOD: The method is based on cellular operations with from/to matrix that describes nurse movements between rooms on a ward. The NMRA can be implemented by traditional manual observation or with a novel internet-of-things solution named SKAnalysis. RESULTS: The greatest nurse flows led to patient rooms, nurses' stations, and medicine rooms. The manual NMRA recorded a total of 3,040 room visits by nurses; visits to patient rooms accounted for 33% of all room visits, while visits to nurses' stations accounted for 28%, and visits to the medicine room for 10%. The internet-of-things NMRA recorded a total of 25,841 room visits by nurses; patient room visits accounted for about 43% of all room visits, while nurses' station visits accounted for 26% and medicine room visits for about 8%. Based on the results, researchers present the development examples and priorities for nursing. CONCLUSIONS: NMRA works and is a new universal method for analyzing nurses' traffic which is a basic premise for improving working methods and productivity on the wards. Internet-of-things solution makes the implementation of NMRA six times more efficient than by the manual NMRA.

Supporting Occupational Health and Safety Risk Assessment Skills: A Case Study of Five Companies.

Financial burden due to poor occupational safety practices remains high although occupational health and safety (OHS) have improved in recent years. Conducting risk assessment is one way to improve OHS. Workplaces may not have sufficient expertise in risk assessment. The aim of this study was to identify the needed OHS risk assessment skills, current support in the workplaces and the ways to improve risk assessment skills. This study was conducted with the Delphi survey for OHS experts (n = 13) and with interviews (n = 41) in the case companies. OHS experts agreed that the most significant skills were for employees to identify hazards and minimize risks in one's work; for supervisors to influence others with a good example; and for OHS experts to understand and manage the wholeness of safety practices and understand and manage the meaning, concepts, and criteria of risk assessment. The current main support methods were learning at work, training and written instructions. However, many of the interviewees felt that they had not received risk assessment training and that the support depended on their activity. Finally, the OHS experts determined that the most feasible ways to improve risk assessment skills were training, coaching and giving clear instructions. Likewise, the interviewees suggested various training methods. Based on these results, concrete development plans to improve risk assessment skills can be made.