Nursing performance and absenteeism in hospital

Introduction: Health care personell management is a key factor for a successful hospital. The assessment of nursing care performance levels (NPL) needed in different wards and case-mix could provide useful information to managers, with reference to amount of workforce and facilities. Sick leave absenteeism rate could also be taken as a tentative indicator of job dissatisfaction to routinely check organizational climate. The aim of the study is the combined analysis of NPL and absenteeism. Methods: A retrospective study was conducted on ill-health absenteeism observed over 2007, based on administrative data colleted from the database of a teaching hospital in Northern Italy with about 3500 employees. The analysis considered registered and auxiliary nurses from 15 wards for which objective and perceived NPLs data were available. They were assessed with ad hoc questionnaire by trained nurses getting data from 1434 nursing and medical records. Roughly 6000 days of absence were collected. Results: Female absenteeism is up to twice fold than male. In both genders, the regression analysis shows weak non-significant relationship: absences decreases for increasing objective NPL, while perceived NPL seems directly related to absenteeism rate only for auxiliary nurses. Absences of nurses lasting only one-day are 40% more frequent than longer periods (RR 1.40; CI 95% 1.16-1.67) when NPL are elevated. This figure is valid only for registered nurses and not for auxiliary nurses. Discussion: Female gender and job title are the principal factors related to absenteeism. The combined analysis of NPL versus absenteeism shows a higher commitment in nurses, who self-reduce the length of sick leave, when nursing care is most needed. A workforce increase into wards characterized by higher NPL, could wider operator’s reserve and therefore lead to enhanced health care personell management.