Factors influencing time management skills among nurses in North West Bank, Palestine

Time is considered one of the most important resources [1]. Using time effectively can have enormous benefits for the individual and for the work environment. Building nurses’ time management skills can improve their well-being and quality of their work [2]. Overworked health professionals and workers’ burnout are related to poor quality of care provided to patients and unsafe care [1]. Good time management will not decrease the workload but will allow greater control over time, the workflow, and will reduce work stress [3]. Effective time management enables nurses to prioritize care, devote their valuable time and attention to the most critical duties first and delegate those that may be waited till later. However, good time management skills do not only assist nurses in prioritizing tasks but also in eliminating unnecessary tasks which would be considered as time wasters [4]. In addition to physical fatigue, shift work, and low decision autonomy, nurses report that shortage of time is one of the most important sources of work stress [4]. Lack of good time management skills can lead to anxiety, burnout, job dissatisfaction, and negative consequences to the whole organization, and finally to quality of patient care [5, 6].

Despite the importance of time management skills in the nursing profession, there is a lack of studies investigating those skills among nurses in the Palestinian context. Therefore, this study aims to explore factors related to time management skills among nurses in Palestine. The findings can be useful for nursing managers, policy makers, and national nursing directors to propose training programs to improve the quality of care. Good time management skills can reduce stress, improve psychological well-being, and increase work productivity. A quasi-experimental study of 60 nurses from all wards in a hospital in Tehran demonstrated improvements in psychological well-being and trust in staff after a one-day educational workshop on the importance of time management, practical strategies of managing time, and causes of wasted nursing time [2]. Another educational intervention of time management skills for head nurses was assessed through a self-administered questionnaire measuring four-time management skills (goal setting and prioritizing, time mechanic, time control, and organization). Results showed that nurses were applying these skills significantly more after the educational intervention, indicating that the educational program could have contributed to their improved performance [7]. Good time management skills can improve the quality of care provided for patients [1]. A pre- post intervention study on the impact of a time management educational pamphlet on nurses’ stress showed effectiveness of this self-learning module in reducing stress among acute care nurses in Egypt [3]. Stress levels as measured by the expanded nursing stress scale in (ENSS) where significantly reduced three months after the intervention. The educational pamphlets contained instructions for nurses on strategies about how to manage time effectively. According to research, effective strategies of time management include (1) Determining goals and objectives, (2) Prioritizing the goals and objectives [8], (3) Listing the activities that need to be done to achieve the goals, (4) Prioritizing the activities [8], (5) Understanding one’s knowledge, skills, and confidence in administrative and clinical work [9], (6) Working smarter not harder [10]. Working smarter includes knowing when and how to delegate tasks, knowing how to automate tasks, knowing how to set priorities, breaking down large tasks to smaller, completing smaller tasks first, and learning how to say no [1].

Background characteristics of the participants are shown in Table 1. About 65.2% of the nurses were females and 34.8 males. The majority were above 35 years of age (43.9%) and held a bachelor degree (57.3%), and live in city (49.2%). Almost 72.6% worked in hospitals and 27.4% in outpatient clinics. Most of participants worked in government institutions (75.1%) while 24.9% worked in private institutions. The majority of nurses (45.3%) had more than 10 years of job experience. Finally, a large percent of the participants (58.0%) attended a time management course.

Table 2 shows that the average total score for the NTMS was 63.39 out of a total score of 90. The highest NTMS score was for “I gather all equipment that will be needed before starting an activity” with mean 3.94, followed by “I document the nursing intervention as soon as possible after the activity is completed” with mean 3.93, and “I maintain a clean work area, and keep your desk organized” with mean 3.91. The lowest score was for " I spend enough time planning” with mean 3.37 followed by “I have a set of goals for the entire week” with mean 3.41 and " I force myself to make time for planning” with mean 3.51.

Table 3 shows the results of the multivariate linear regression. Females obtained a slightly lower scores than males, coefficient = -2.36, p = 0.043. Nurses in primary care centers had significantly higher scores than nurses who work at hospitals, coefficient = 4.47, p = 0.004. The type of healthcare organization emerged as a significant factor predicting time management skills. Nurses in private hospitals had worse time management skills than nurses in government hospitals, coefficient = -12.27, p < 0.001.

Nurse supervisors had better time management skills than staff nurses, coefficient = 4.01, p = 0.023. Nurses working in non-teaching hospitals had worse time management skills than nurses in teaching hospitals, coefficient = − 3.86, p = 0.001. Nurses who did not attend a time management course had worse time management skills than nurses who attended time management course, coefficient = − 4.05, p = p < 0.001.