Analysis of the nurse workload and impact of patient volume and flow in a Surgical ICU

Enfermeria intensiva Pub Date : 2025-04-01 DOI:10.1016/j.enfie.2025.500535

Amaia Gutiérrez-Abarca MSN, Alberto Casado-Álvarez MSN, Sare Espinosa-Carcabilla MSN

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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. Calculation of the NW of each reason for admission relating the stay average and its NAS and VACTE average. 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.

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外科ICU护士工作量及对患者数量和流量的影响分析

护士对病人（N:P）比率差对病人和专业人员的健康都有负面影响。有几个工具来量化护士工作量（NW）和调整护士人员配置。在重症监护室（ICU）使用这些工具可以促进护理资源适应患者的实际需求，改善工作条件。目的确定外科ICU病房的NW。方法：于2023年3月至4月进行描述性、横向和单中心研究。使用“护理活动评分”（NAS）确定适合NW的手术N:P比率。使用NAS和“Valoración de Cargas de Trabajo y Tiempos de Enfermería”（VACTE）量表以及拟议的西北地区指标对西北地区进行测量。运用“工作利用率”指标分析护理资源的管理与效益。确定工作量较大的工作日和班次。NAS和VACTE与入院原因的双变量分析。计算每项入院原因的平均逗留时间，以及平均逗留时间和平均逗留时间。量表间的相关分析。结果每个量表共收集记录1705条。每位患者NAS中位数：55.70 (IR: 51.30 ~ 60.38), （95%CI: 54.74 ~ 56.66）。每位患者NAS平均：56,67 (SD：±8,28),（95%CI: 55.72 ~ 57.63）。NW每床NAS: 63.39, VACTE: 652.93。护士人均NAS: 135.23%。B:P: 1:1.09。有效市盈率：1:1.76。WUR祝辞1. 量表间相关系数为0.45。结论护理人员的短缺与所产生的工作有关。天平需要更新。对于护理人员的充足性而言，每位护士的NAS比每位患者的NAS更有效。新提出的指标可能适用于NW的确定和护理资源的优化计算。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Enfermeria intensiva

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