Direct and Indirect Nursing Activities in Three Home Care Settings in Italy: An Observational Time and Motion Study

Background Home nursing care is increasing in Italy due to chronic disease expansion and population aging. This study aimed to describe the types of home nursing activities performed in two home care settings and estimate the time dedicated to them. Methods A cross‐sectional observational time‐and‐motion study was conducted in three local health authorities in northern and central Italy. Time spent on activities was recorded as total and average time per nurse. Average care time was estimated using linear multilevel mixed effects models. Results Forty‐four activities were recorded across 527 visits. A total of 300 nurses (81.33% female) reported 343 h of activities: 221 hs (64.29%) on direct care and 123 h (35.71%) on indirect activities. The most time‐consuming direct activities were patient assessment (54 h), pressure ulcer dressing (27 h), vascular wound dressing (22 h), and bandage application (21 h). The longest indirect activities were managing nursing documentation (62 h) and traveling to patients’ homes (48 h). Conclusion Time nurses spent in this study on direct care outperformed the time allocated for indirect care. However, other important direct nursing activities were not performed, including family involvement in the care process and patient self‐care education.