Repercussions of moving patients on the context of practice: perspectives of the nursing team^*

Objective:   to examine the nursing team’s view of the repercussions of moving patients (admissions, transfers and discharges) on the organization of work and the delivery of care.

Method:   this is a qualitative study using the focus group technique, conducted with 23 professionals - 12 nurses, eight nurse technicians and three nurse assistants working in three inpatient units at a teaching hospital in the countryside of Sao Paulo. Four meetings took place between November 2021 and March 2022. The reports were analyzed thematically using MAXQDA software.

Results:   two thematic categories emerged: the influence of structural factors and work organization on the intra-hospital moving of patients; it demands time, generates work overload and interferes with the delivery of care.

Conclusion:   the volume of moving patient associated with unforeseen demands, care complexity and insufficient staff and resources have a negative impact on the delivery of care, with clinical risks and work overload. The findings make it possible to improve the regulation of patients entering and leaving the units, work organization and care management, avoiding clinical risks, delays, omissions and work overload.

Descriptors:  Patient Transfer; Workflow; Nursing Staff; Workload; Health Care Process Assessment; Practice Management

Highlights:

(1) Moving patients around the hospital requires structure and work organization.

(2) Nursing estimates dedicating 10-15 minutes to 2-3 hours of work on these interventions.

(3) Frequency, unpredictability and complexity of care have a negative impact on care.

(4) Unfavorable conditions for moving generate care and occupational risks.