Measuring nurses’ on-shift physical activity and sedentary time by accelerometry or heart rate monitoring: A descriptive case study illustrating the importance of context

Background There is debate whether nurses are active enough stemming from differences in measurement tools, clinical contexts, and nursing tasks. A descriptive case study concerning the use of device-based measures in combination with direct observation is presented to examine the effect of the nursing context and the discrepancies between different measurement tools for identifying nurses’ on-shift activity levels. Methods Data were collected across seven shifts in medical and surgical wards. Nurses’ activity was assessed using accelerometry and heart rate monitoring, in addition to direct observation. Data graphs were plotted for each shift and measurement device, with direct observations used to contextualise the data and identify discrepancies. Results Higher activity levels were recorded on-shift through heart rate monitoring (87%) compared to accelerometry (27%). This pattern was also observed specifically on early, late, and medical ward shifts. Data discrepancies between the two devices stemmed from the shift and (or) ward type, highlighting the importance of understanding the context of nursing duties when assessing nurses’ activity levels. Conclusions It is also vital that researchers, policymakers, and practitioners consider how they will measure nurses’ occupational physical activity, which consequently will influence outcomes, and therefore, decisions around the need (or not) for intervention.