Identification of nursing workload in the Sterile Processing Department

Quantitative, observational study conducted in four hospitals in the city of São Paulo, in three steps: mapping of activities in work positions; determination of the standard processing time of materials; and establishment of the average daily workload.

Results

In the 15 mapped work positions, 1315 samples of time were obtained. As the time values did not show significant differences, it was possible to determine the standard processing time of materials. The average daily workloads corresponded to 217.4; 294.0; 123.1; and 189.1 hours.

Conclusion

In addition to proposing a method to determine the workload, the present study indicates parameters for the processing of materials and serves as an important reference to develop consistent proposals for the planning, allocation and distribution of nursing staff in these departments.

Nursing Staff; Workload; Sterilization; Materials Management; Hospital

Area	Work position	Production indicator
A – Dirty or contaminated (purge)	1) Reception of materials from consumer units	Number of kits received by the Sterile Processing Department
A – Dirty or contaminated (purge)	2) Cleaning of materials	Number of kits processed by the Sterile Processing Department
B – Control of consignment materials	3) Reception of consignment materials	Number of kits received
	4) Consignment materials check after surgery	Number of kits checked
	5) Return of consignment materials to supplier companies	Number of kits returned
C – Preparation of materials	6) Drying of materials and distribution on the preparation benches	Number of kits processed by the Sterile Processing Department
	7) Inspection, testing and separation of clean materials or instruments	Number of instrumental kits processed
	8) Assembly and packaging of materials and instruments	Number of instrumental kits processed
	9) Assembly and packaging of mechanical ventilation kits or circuits	Number of mechanical ventilation kits processed
D – Sterilization of materials	10) Load assembly and monitoring of sterilization cycle	Number of loads/cycles performed
E - Storage and distribution of sterile materials	11) Removal of the sterile load from equipment and checking of the effectiveness of the sterilization process	Number of loads/cycles performed
	12) Storage of sterile materials and clothes	Number of loads/cycles performed
	13) Assembly of transport trolleys to consumer units	Number of trolleys assembled
	14) Organization and control of the environment and sterile materials	Number of kits processed by the Sterile Processing Department
	15) Distribution of materials and sterile clothing to consumer units	Number of kits processed by the Sterile Processing Department

Area	Work positions	Description of the activity	CME	Daily average of kits	Standard time (min)	Average daily workload (hours/day)
A	1	Reception and collection of materials	I	765	1.94	24.7
			II	1083	1.94	35.0
			III	359	1.94	11.6
			IV	686	1.94	22.2
	2	Cleaning of materials	I	785	2.41	31.5
			II	1127	2.41	45.3
			III	359	2.41	14.4
			IV	695	2.41	27.9
B	3	Receipt of consignment materials	I	20	5.67	1.9
			II	44	5.67	4.2
			III	10	5.67	0.9
			IV	8	5.67	0.8
B	4	Consignment materials check after surgery	I	20	8.99	3.0
			II	44	8.99	6.6
			III	10	8.99	1.5
			IV	8	8.99	1.2
	5	Return of consignment materials	I	20	2.67	0.9
			II	44	2.67	2.0
			III	10	2.67	0.4
			IV	8	2.67	0.4
C	6	Drying and distribution of materials after cleaning	I	785	2.94	38.5
			II	1127	2.94	55.2
			III	359	2.94	17.6
			IV	695	2.94	34.1
	7	Inspection, testing, separation and drying of materials	I	675	2.73	30.7
			II	663	2.73	30.2
			III	359	2.73	16.3
			IV	543	2.73	24.7
	8	Assembly and packaging of materials	I	675	2.84	32.0
			II	663	2.84	31.4
			III	463	2.84	21.9
			IV	543	2.84	25.7
	9	Assembly of mechanical ventilation materials	I	106	1.55	2.7
			II	464	1.55	12.0
			III	0	1.55	0.0
			IV	148	1.55	3.8
D	10	Assembly of the sterilization load	I	25	8.01	3.3
			II	32	8.01	4.3
			III	20	8.01	2.7
			IV	35	8.01	4.7
E	11	Removal of sterile load from and checking of sterilization	I	25	2.72	1.1
			II	32	2.72	1.5
			III	20	2.72	0.9
			IV	35	2.72	1.6
	12	Storage of materials	I	25	3.55	1.5
			II	32	3.55	1.9
			III	20	3.55	1.2
			IV	35	3.55	2.1
	13	Assembly of the unit transport trolleys	I	39	5.49	3.6
			II	47	5.49	4.3
			III	23	5.49	2.1
			IV	32	5.49	2.9
	14	Organization and control of the environment and sterile materials	I	785	1.08	14.1
			II	1127	1.08	20.3
			III	588	1.08	10.6
			IV	695	1.08	12.5
E	15	Distribution of materials and sterile clothing	I	785	2.13	27.9
			II	1127	2.13	40.0
			III	588	2.13	20.9
			IV	695	2.13	24.7

Area	Work position	Description of activity	Average daily workload (hours/day)

			CME I	CME II	CME III	CME IV
A	1	Reception and collection of materials	24.7	35.0	11.6	22.2
A	2	Cleaning of materials	31.5	45.3	14.4	27.9
B	3	Receipt of consignment materials	1.9	4.2	0.9	0.8
	4	Consignment materials check after surgery	3.0	6.6	1.5	1.2
	5	Return of consignment materials	0.9	2.0	0.4	0.4
C	6	Drying and distribution of materials after cleaning	38.5	55.2	17.6	34.1
	7	Inspection, testing, separation and drying of materials	30.7	30.2	16.3	24.7
	8	Assembly and packaging of materials	32.0	31.4	21.9	25.7
	9	Assembly of mechanical ventilation materials	2.7	12.0	0.0	3.8
D	10	Assembly of the sterilization load	3.3	4.3	2.7	4.7
E	11	Removal of sterile load from and checking of sterilization	1.1	1.5	0.9	1.6
	12	Storage of materials	1.5	1.9	1.2	2.1
	13	Assembly of the unit transport trolleys	3.6	4.3	2.1	2.9
	14	Organization and control of the environment and sterile materials	14.1	20.3	10.6	12.5
	15	Distribution of materials and sterile clothing	27.9	40.0	20.9	24.7
Total average daily workload			217.4	294.0	123.1	189.1

VARIABLES	CME

	I	II	III	IV
Total average daily workload - $q_{t e c}$	217.4	294.0	123.1	189.1
Working hours (hours) - t	6	6	6	6
Number of nursing professionals - q_tec	36	49	21	32
Technical safety index (IST)	1.15	1.15	1.20	1.15
Expected nursing staff – Q _cme	42	56	25	36
Observed nursing staff	35	52	28	48
Chi square test	1.07	0.33	0.47	3.81
Calculated chi square	5.68
Critical value a=0.05 3 DF	7.82

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding author: Janaína Anchieta Costa Universidade Federal de São Paulo Rua Sena Madureira, 1500, Vila Clementino CEP 04021- 001 – São Paulo, SP, Brazil janaenfe@gmail.com