Direct versus Indirect Nursing Care in Intensive Care Units during COVID-19 (An Observational Study).

Abstract

Background: Nurses play a crucial role in providing care in Intensive Care Units (ICUs). This study aimed to compare the time spent and types of direct and indirect nursing care provided to patients during COVID-19 pandemic.

Materials and methods: This observational study was conducted in the ICU of Hafthome-Tir Hospital, Tehran, in 2022. The activities of 42 randomly selected nurses were continuously observed and recorded, focusing on direct and indirect care as per the revised International Classification for Nursing Practice checklist. Data were analyzed using dependent t-test (p > 0.05).

Results: The data showed that the highest average time for direct care spent on cardiopulmonary resuscitation was 27.30 (6.10) minutes, while the least time for deltoid injections was 4.8 (2.9) minutes. In indirect care, the most time was spent writing reports, 34.90 (10.50) minutes, and the least time spent removing personal protective equipment was 6.11 (3.19) minutes. During data collection, 19 procedures were added to the nursing care checklist due to COVID-19. A dependent t-test showed a significant difference between direct and indirect ICU nursing care (t= -6.62, df = 41, p < 0.001), indicating more time was spent on indirect care.

Conclusions: The findings showed indirect care was provided more frequently than direct care, highlighting the need to reassess nursing care delivery methods. The increased demand for indirect care is attributed to time and staffing shortages, along with a rise in patient numbers and hospitalizations compared to pre-COVID conditions.