Objectives: The aims of our study are to devise a simulation method to estimate nurses' and care workers' necessary working hours (NWH) based on a clinical path (CP) and to consider the reasonableness of the simulation. The TNS (Toranomon Nursing System), KNS (Kitasato Nursing System), and“ intensity of nursing care needs” are widely used simulations to estimate the time needed for providing nursing care. However, these methods are not based on a CP. Therefore, we devised a simulation method based on the CP in a three-day course of cardiac catheter tests, and applied the method to the case of parallel processing the CP to estimate the NWH of a nurse and a care worker.

Methods: The simulation procedures were as follows: 1) breaking each element of treatment and care into detailed units; 2) measuring the minutes needed to perform the unit; 3) planning a four-week schedule for the parallel processing of the CP among patients and assigning nurses and care workers for the processing; 4) totaling up the minutes needed to perform the units as a factor of each nurse’s or care worker's NWH per actual hour in each 24-hour day for four weeks.

Results: Analysis of values obtained by the simulation show the following: a nurse or care worker's NWH values are determined by the point along the CP that the patient under his/her care has reached; the NHW value depends on how many hospitalizations, discharges, and examinations are scheduled on each day of the week, and; if an NWH value per hour is greater than 1.0, it will cause a delay in the corresponding care. These results are consistent with actual conditions, and the simulation method is considered reasonable.

Conclusion: Our simulation method is reasonable for estimating the NWH of nurses and care workers.