This study examines the application of the Project Research in Nursing (PRN) patient classification/workload measurement system in a teaching hospital in Quebec. It also compares the workload estimates of direct and indirect care activities determined from patients' total PRN point scores and from corresponding PRN levels of care (classes 1-15). This study examines the allocation and the rankings of patients' needs for nursing care in relation to the categories of the classification instrument. Two documentary sources, audit records of 1988-1989 to 1992-1993 and audit data collection forms of 1992-1993 were used to conduct the study and to provide a comparison of the results. Audit findings were relatively consistent over the five-year period. Comparison of pre-audit and post-audit workload estimates provided detailed information on the measurement sensitivity between total PRN point scores and PRN levels of care; the direction and magnitude of differences between classification ratings; and the distinctive nature of patients' needs for nursing care within and across clinical departments. This study discusses the implications of these findings for nursing resource management decisions, staffing and workload and makes recommendations for practice and further research.

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