{"title":"Objective assessment of nursing workload in an intermediate care unit: A prospective observational study","authors":"","doi":"10.1016/j.iccn.2024.103767","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>To systematically assess the nursing workload in an Intermediate Care Unit.</p></div><div><h3>Design</h3><p>Single-centre prospective observational study. The nursing activities within the initial 72 h of hospitalization were recorded on a prespecified chart and standardized as activities/5 min/patient/day.</p></div><div><h3>Setting</h3><p>This study was conducted at the Intermediate Care Unit of the Altovicentino Hospital (Italy) from September 1 to December 31, 2022.</p></div><div><h3>Main outcome measure</h3><p>We considered working overload as an average number of nursing activities/5 min/patient/day higher than the 85th percentile and investigated independent risk factors associated with it.</p></div><div><h3>Results</h3><p>A total of 183 patients were included. During their hospital stay, the average number of nursing activities per patient was 30 per 5-minute interval per day (range: 22–40). On the first day of hospitalization, the primary activities were predominantly administrative and managerial tasks. In contrast, on the second day, activities related to therapeutic management and primary care predominated. Various scores related to the patient’s condition, including comorbidity, functionality, frailty, intensity, and severity, were analyzed for their association with nursing workload using multivariate analysis. However, only the National Early Warning Score was found to be an independent risk factor for nursing workload overload (OR 1.399, 95 % CI 1.205–1.624, p < 0.001).</p></div><div><h3>Conclusion</h3><p>The study results demonstrated a significant variation in nursing workload within the same department. Subsequent studies are necessary to confirm the ability of the National Early Warning Score in predicting nursing over workload.</p></div><div><h3>Implication for clinical practice</h3><p>This study provides a detailed analysis of nursing workload in intermediate care settings, emphasizing the need for adequate resource allocation due to the potential for rapid deterioration in patients’ conditions. By correlating nursing activities with patient severity indices, such as the National Early Warning Score, the findings support more effective organizational strategies to enhance care for patients at high risk of health decline.</p></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":null,"pages":null},"PeriodicalIF":4.9000,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Intensive and Critical Care Nursing","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0964339724001526","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives
To systematically assess the nursing workload in an Intermediate Care Unit.
Design
Single-centre prospective observational study. The nursing activities within the initial 72 h of hospitalization were recorded on a prespecified chart and standardized as activities/5 min/patient/day.
Setting
This study was conducted at the Intermediate Care Unit of the Altovicentino Hospital (Italy) from September 1 to December 31, 2022.
Main outcome measure
We considered working overload as an average number of nursing activities/5 min/patient/day higher than the 85th percentile and investigated independent risk factors associated with it.
Results
A total of 183 patients were included. During their hospital stay, the average number of nursing activities per patient was 30 per 5-minute interval per day (range: 22–40). On the first day of hospitalization, the primary activities were predominantly administrative and managerial tasks. In contrast, on the second day, activities related to therapeutic management and primary care predominated. Various scores related to the patient’s condition, including comorbidity, functionality, frailty, intensity, and severity, were analyzed for their association with nursing workload using multivariate analysis. However, only the National Early Warning Score was found to be an independent risk factor for nursing workload overload (OR 1.399, 95 % CI 1.205–1.624, p < 0.001).
Conclusion
The study results demonstrated a significant variation in nursing workload within the same department. Subsequent studies are necessary to confirm the ability of the National Early Warning Score in predicting nursing over workload.
Implication for clinical practice
This study provides a detailed analysis of nursing workload in intermediate care settings, emphasizing the need for adequate resource allocation due to the potential for rapid deterioration in patients’ conditions. By correlating nursing activities with patient severity indices, such as the National Early Warning Score, the findings support more effective organizational strategies to enhance care for patients at high risk of health decline.
期刊介绍：
The aims of Intensive and Critical Care Nursing are to promote excellence of care of critically ill patients by specialist nurses and their professional colleagues; to provide an international and interdisciplinary forum for the publication, dissemination and exchange of research findings, experience and ideas; to develop and enhance the knowledge, skills, attitudes and creative thinking essential to good critical care nursing practice. The journal publishes reviews, updates and feature articles in addition to original papers and significant preliminary communications. Articles may deal with any part of practice including relevant clinical, research, educational, psychological and technological aspects.
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