In the RAFAELA patient classification system, the professional assessment of optimal nursing care intensity level (PAONCIL)\ninstrument is used to assess the optimal nursing intensity level per unit. The PAONCIL instrument contains an overall assessment\nof the actual nursing intensity level and an additional list of central nonpatient factors that may increase or decrease the total\nnursing workload (NWL). The aimof this cross-sectional study was to assess and determine which nonpatient factors affect nursesââ?¬â?¢\nexperiences of their total NWL in both outpatient settings and hospitals, as captured through the PAONCIL instrument. The\ndata material consisted of PAONCIL questionnaires from 38 units and 37 outpatient clinics at 11 strategically selected hospitals\nin Finland, and included nursesââ?¬â?¢ answers (n = 1307) to the question of which factors, other than nursing intensity, affect total\nNWL. The methods for data analyses were qualitative content analyses. The nonpatient factors that affected nursesââ?¬â?¢ experiences of\ntotal NWL are ââ?¬Å?organization of work,ââ?¬Â ââ?¬Å?working conditions,ââ?¬Â ââ?¬Å?self-control,ââ?¬Â and ââ?¬Å?cooperation.ââ?¬ÂThe actual list of nonpatient factors\nin the PAONCIL instrument is to a reasonable extent relevant, but the list should be improved to include nursesââ?¬â?¢ actual working\nconditions and self-control.
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