Nurses' Burden of Elimination Care: Sequential Explanatory Mixed-Methods Design

Se Young Jung; Hui-Woun Moon; Da Som Me Park; Sumi Sung; Hyesil Jung

doi:10.2147/IJGM.S424424

Nurses' Burden of Elimination Care: Sequential Explanatory Mixed-Methods Design

Int J Gen Med. 2023 Sep 6:16:4067-4076. doi: 10.2147/IJGM.S424424. eCollection 2023.

Authors

Se Young Jung^{1

2}, Hui-Woun Moon², Da Som Me Park², Sumi Sung³, Hyesil Jung⁴

Affiliations

¹ Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
² Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
³ Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
⁴ Department of Nursing, College of Medicine, Inha University, Incheon, Republic of Korea.

Abstract

Background: Inpatients commonly experience problems with elimination due to incontinence, urinary retentions, and complications with indwelling catheters. Although elimination care (EC) is an important nursing area, few studies explore the burden of EC on nurses.

Aim: To identify the burden on EC by analyzing nurses' opinions using sequential explanatory mixed method.

Methods: This research was conducted using a sequential explanatory mixed-methods design. A total of 59 nurses at a tertiary hospital in South Korea participated in the study from January 1 to March 31, 2022. For quantitative analysis, information about number of delays of work due to EC, required time for serving bedpan or diaper changes, percentage of EC per shift, and percentage of patients who need EC was collected through a survey. For qualitative analysis, focus group interviews were conducted to identify factors that put a burden on EC. Important themes were derived by analyzing nurses' opinions on EC.

Results: For nurses in intensive care units, general wards, and integrated nursing care wards, the number of work delays due to EC was 3.6 ± 1.5, 2.3 ± 1.2, and 4.8 ± 2.4 (p<0.01), respectively. The mean percentage of EC work out of total nursing tasks per shift was 36.2 ± 19.0, 29.3 ± 14.4, and 43.8 ± 14.1 (p=0.02), respectively. The mean percentage of patients requiring EC out of patients a nurse cares was 85.4 ± 16.6, 41.3 ± 26.1, and 58.8 ± 21.9 (p<0.01), respectively. Following qualitative analysis, four themes related to nurses' EC burden were derived: physical burden, frequent care needs, delay of other jobs due to EC, and complications. Among them, frequent care needs were found to be the primary factor requiring consideration to reduce nurses' burden.

Conclusion: This research found that EC is one of the most burdensome tasks that nurses want to avoid. To alleviate their burden, effective EC protocol or smart medical devices assisting with EC should be developed.

Keywords: elimination care; mixed-methods approach; nursing.

Grants and funding

This work was supported by the Korea Medical Device Development Fund grant funded by the South Korean government (Ministry of Science and ICT, Ministry of Trade, Industry and Energy, Ministry of Health & Welfare, Ministry of Food and Drug Safety; Project Number: 202016B03, KMDF_PR_20200901_0157).