Public Health Nurses' Time Allocation in Local Government Nursing Settings: A Self‐Reported Prospective Time Study

ABSTRACT

Aim

To clarify how public health nurses allocate their time across various tasks and compare time-use patterns between prefectural and municipal public health nurses in Japan, where distinct administrative mandates define their roles.

Design

A self-reported, prospective time study.

Methods

Public health nurses from two municipalities and one prefecture recorded their daily practices and time allocations using Kintone. Time allocation differences by administrative level and job position were analysed using linear mixed-effects models.

Results

Overall, 121 participants contributed 9502 person-days of data. Participants spent an average of 463.6 min/workday on work-related activities. Municipal public health nurses dedicated more time to application paperwork (64.0 min), health examinations (57.6 min), and individual coordination (48.3 min). Prefectural public health nurses allocated more time to business management and organisational operations (69.0 min) and traveliing, particularly in rural contexts. Managers spent less time on direct care and more on administrative tasks.

Conclusion

This study provides the first quantitative, self-reported evidence of task distribution among public health nurses across administrative levels and positions. The findings reflect structural differences in role expectations and underscore the need to reallocate workloads to better align with each level's mandate.

Implications for the Profession

Task prioritisation, information and communication technology tool integration, and administrative support are essential in optimising public health nurses' contributions to community health. These strategies can reduce non-clinical workload and enable public health nurses to focus on high-impact, value-added public health services that promote health equity.

Impact

This study closes a longstanding gap by quantifying PHNs' time allocation, revealing the hidden burden of administrative work, and providing critical insights for workforce planning and sustainable public health service delivery.

Reporting Method

This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology guideline.

Patient or Public Contribution

No Patient or Public Involvement.

Trial Registration

UMIN Clinical Trials Registry; UMIN000051509 (https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_his_list.cgi?recptno=R000058761; August 1, 2023)