Serena Sibilio, Arian Zaboli, Marta Parodi, Paolo Ferretto, Daniela Milazzo, Monica Trentin, Francesca Stefani, Elisa Mantiero, Francesco Brigo, Massimo Marchetti, Gianni Turcato
{"title":"Challenges and peculiarities of nursing activities in intermediate care units compared with internal medicine wards: A prospective study.","authors":"Serena Sibilio, Arian Zaboli, Marta Parodi, Paolo Ferretto, Daniela Milazzo, Monica Trentin, Francesca Stefani, Elisa Mantiero, Francesco Brigo, Massimo Marchetti, Gianni Turcato","doi":"10.1111/nicc.13155","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Intermediate Care Units (IMCs) are specialized facilities located within other departments in many Western countries. They are designed to manage patients with conditions that are not severe enough to require an intensive care unit. IMCs aim to fill the gap between regular wards and intensive care units, necessitating an adequate allocation of nursing resources.</p><p><strong>Aims: </strong>The aims of the study are to (1) evaluate and compare the nursing workload for patients admitted to a regular ward or to an IMC; (2) quantify nursing workload in terms of activities and time spent to perform them; and (3) evaluate which patient characteristics predict nursing work overload.</p><p><strong>Study design and methods: </strong>This is an observational, prospective, single-centre study. We included patients admitted to the Internal Medicine department in a general hospital in Italy, between 1 September and 31 December 2022, either in the regular ward or in the IMC. Clinical characteristics, comorbidity, functionality, frailty, severity and acuity of patients were recorded using validated assessment tools. Nursing activities in the first 3 days of hospitalization were recorded and standardized as activities/5 min/patient/day. An average number of nursing activities/5 min/patient/day exceeding the 85th percentile was considered nursing work overload. Multivariate logistic regression models were conducted to identify patient-related risk factors associated with nursing work overload.</p><p><strong>Results: </strong>We included 333 patients, 55% (183/333) admitted to the IMC and 45% (150/333) to the regular ward. In the IMC, the average nursing activities were 32.4/5 min/patient/day compared with 22.6 in the regular ward. Nursing work overload was found in 6% (9/150) of patients admitted to the regular ward compared with 23% (42/183) in the IMC.</p><p><strong>Conclusion: </strong>There is a significantly higher demand for nursing care among patients in the IMC, with higher daily average of nursing activities.</p><p><strong>Relevance to clinical practice: </strong>The allocation of nursing resources within the IMC should be greater than in the regular ward because of higher workload.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13155"},"PeriodicalIF":3.0000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nursing in Critical Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/nicc.13155","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/22 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Intermediate Care Units (IMCs) are specialized facilities located within other departments in many Western countries. They are designed to manage patients with conditions that are not severe enough to require an intensive care unit. IMCs aim to fill the gap between regular wards and intensive care units, necessitating an adequate allocation of nursing resources.
Aims: The aims of the study are to (1) evaluate and compare the nursing workload for patients admitted to a regular ward or to an IMC; (2) quantify nursing workload in terms of activities and time spent to perform them; and (3) evaluate which patient characteristics predict nursing work overload.
Study design and methods: This is an observational, prospective, single-centre study. We included patients admitted to the Internal Medicine department in a general hospital in Italy, between 1 September and 31 December 2022, either in the regular ward or in the IMC. Clinical characteristics, comorbidity, functionality, frailty, severity and acuity of patients were recorded using validated assessment tools. Nursing activities in the first 3 days of hospitalization were recorded and standardized as activities/5 min/patient/day. An average number of nursing activities/5 min/patient/day exceeding the 85th percentile was considered nursing work overload. Multivariate logistic regression models were conducted to identify patient-related risk factors associated with nursing work overload.
Results: We included 333 patients, 55% (183/333) admitted to the IMC and 45% (150/333) to the regular ward. In the IMC, the average nursing activities were 32.4/5 min/patient/day compared with 22.6 in the regular ward. Nursing work overload was found in 6% (9/150) of patients admitted to the regular ward compared with 23% (42/183) in the IMC.
Conclusion: There is a significantly higher demand for nursing care among patients in the IMC, with higher daily average of nursing activities.
Relevance to clinical practice: The allocation of nursing resources within the IMC should be greater than in the regular ward because of higher workload.
期刊介绍：
Nursing in Critical Care is an international peer-reviewed journal covering any aspect of critical care nursing practice, research, education or management. Critical care nursing is defined as the whole spectrum of skills, knowledge and attitudes utilised by practitioners in any setting where adults or children, and their families, are experiencing acute and critical illness. Such settings encompass general and specialist hospitals, and the community. Nursing in Critical Care covers the diverse specialities of critical care nursing including surgery, medicine, cardiac, renal, neurosciences, haematology, obstetrics, accident and emergency, neonatal nursing and paediatrics.
Papers published in the journal normally fall into one of the following categories:
-research reports
-literature reviews
-developments in practice, education or management
-reflections on practice
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