Understanding the Role of Staff Nurses in Hypertension Management in Primary Care Facilities in India: A Time-Motion Study

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Krishna, Ashish ; Murali, Sharan ; Moran, Andrew E. ; Saxena, Ashish ; Gill, Sandeep Singh ; Hering, Dagmara ; Kaur, Prabhdeep
• Description:
  Introduction
  
  India is facing a shortage of staff nurses; thus, a better understanding of nurses’ workloads is essential for improving and implementing noncommunicable disease (NCD) control strategies. We estimated the proportion of time spent by staff nurses on hypertension and other NCD activities in primary care facilities in 2 states in India.
  
  Methods
  
  We conducted a cross-sectional study in 6 purposively selected primary care facilities in Punjab and Madhya Pradesh during July through September 2021. We used a standardized stopwatch to collect data for time spent on direct hypertension activities (measuring blood pressure, counseling, recording blood pressure measurement, and other NCD-related activities), indirect hypertension activities (data management, patient follow-up calls), and non-NCD activities. We used the Mann-Whitney U test to compare the median time spent on activities between facilities using paper-based records and the Simple mobile device–based app (open-source software).
  
  Results
  
  Six staff nurses were observed for 213 person-hours. Nurses spent 111 person-hours (52%; 95% CI, 45%–59%) on direct hypertension activities and 30 person-hours (14%; 95% CI, 10%–19%) on indirect hypertension activities. The time spent on blood pressure measurement (34 minutes) and documentation (35 minutes) was the maximum time on any given day. Facilities that used paper records spent more median time (39 [IQR, 26–62] minutes) for indirect hypertension activities than those using the Simple app (15 [IQR, 11–19] minutes; P < .001).
  
  Conclusion
  
  Our study found that hypertension activities required more than half of nurses’ time in India’s primary care facilities. Digital systems can help to reduce the time spent on indirect hypertension activities.
  
  
• Subjects:
  Cross-Sectional Studies Humans Hypertension Primary Health Care
• Source:
  Prev Chronic Dis. 2023; 20
• DOI:
  http://dx.doi.org/10.5888/pcd20.220232
• ISSN:
  1545-1151
• Pubmed ID:
  37200503
• Pubmed Central ID:
  PMC10199685
• Document Type:
  Journal Article
• Place as Subject:
  India
• Volume:
  20
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:2ea2bf8ec1312e1af398412c6993b7f11071b303e83d12d49277da4ed4eecc5a2e3c9a58d72eda5de86806cd66c5773bc8a37bb4cfe39c20045d658ac7a33571
• Download URL:
  https://stacks.cdc.gov/view/cdc/151008/cdc_151008_DS1.pdf
• File Type:
  [PDF - 421.20 KB ]