Análisis de la carga de trabajo enfermero e impacto del volumen y flujo de pacientes en una UCI quirúrgica

Abstract

Introduction

A poor Nurse-to-Patient (N:P) ratio has a negative impact on the health of both patients and professionals. There are several tools to quantify the Nurse Workload (NW) and adjust nurse staffing. The use of such tools in the Intensive Care Units (ICU) can facilitate the adaptation of Nursing resources to patients’ real needs and improve working conditions.

Objective

To determine the NW in a Surgical ICU.

Methodology

Descriptive, transversal and unicentric study during March and April 2023. Determination of the operative N:P ratio adequated to the NW using the “Nursing Activities Score” (NAS). Measurement of the NW using NAS and “Valoración de Cargas de Trabajo y Tiempos de Enfermería” (VACTE) scales, together with the proposed NW indicators. Management and efficiency analysis of the Nursing Resources using the “Work Utilization Ratio” Index (WUR). Identification of work days and shifts with greater workload. Bivariate analysis relating NAS and VACTE to reason for admission. NW calculation relating number of scales and NAS and VACTE average of each reason for admission. Correlation analysis between scales.

Results

1705 records per scale were collected. NAS per patient median: 55.70 (IR: 51.30-60.38) (95%CI: 54.74-56.66). NAS per patient mean: 56,67 (SD: ± 8,28) (95%CI: 55.72-57.63). NW per bed NAS: 63.39, VACTE: 652.93. NAS per nurse: 135.23%. B:P Ratio: 1:1.09. Operative N:P Ratio: 1:1.76. WUR >1. Correlation coefficient between scales: 0.45.

Conclusions

There is a shortage of nurses in relation to the work generated. An update in the scales is required. The NAS per nurse is more effective than the NAS per patient for the adequacy of the Nursing workforce. The new proposed indicators might be suitable to determine the NW and to optimize the calculation of Nursing resources.