The cost of transferring a patient on nurses and nursing work

![CDATA[Background: Increasingly in Australia and elsewhere, patients are being transferred between and within wards during their inpatient episode (Blay et al. 2017). Transferring patients is considered to be part of the nursing role, although many nurses believe that some transfer activities could be delegated to others (Bruyneel et al. 2013). This study explores patient transfers in terms of nursing roles and nursing work. Aims: To explore the impact of transferring patients on medical-surgical nurses and nursing work in a tertiary level hospital in Australia. Methods: A direct observational-timing study of nurses undertaking transfer-associated activities between June and August 2013. Observed nursing activities were timed and categorised into pre-determined categories (Administration, Communication, Direct care, Documentation, Indirect care and Other) based on work sampling methods. Case studies were used to detail the sequence of nursing activities and nursing roles. Field notes recorded at the time of observation provide insight into the transfer process. Results: Nurses were observed and timed undertaking transfer-associated activities (n=868). Communicative activities were the most frequently undertaken activity (36%) followed by direct care 31%. The majority of nurse’s time (46%) was spent on direct care. Escorting a patient was the most time-consuming, taking nurses away from the ward for 19 minutes on average. Similar proportions of time were spent on documentation (13%) and administrative (11%) activities. Experienced nurses spent 17% of their time on indirect care and other activities such as moving beds and bedside lockers. Discussion: The frequency of patient transfers is such that nurses are spending considerable time moving patients. Results have highlighted that many transfer-associated activities were costly in terms of nursing time and could be undertaken by others.]]