Workload assessment using the nursing activities score in intensive care units: Nationwide prospective observational study in France.

Autor: Dauvergne JE; Nantes Université, CHU Nantes, Department of Anesthesiology and Critical Care, Laënnec Hospital, F-44000 Nantes, France; Nantes Université, CHU Nantes, CNRS, INSERM, l'Institut du Thorax, F-44000 Nantes, France. Electronic address: jerome.dauvergne@chu-nantes.fr., Bruyneel A; Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium. Electronic address: arnaud.bruyneel@ulb.be., Caillet A; Hospices Civils de Lyon, Hospital Center Lyon-Sud, Intensive Care Unit, F-69310 Pierre-Bénite, France. Electronic address: anaelle.caillet@chu-lyon.fr., Caillet P; Nantes Université, CHU Nantes, Public Health Department, F-44000 Nantes, France. Electronic address: pascal.caillet@chu-nantes.fr., Keriven-Dessomme B; Nantes Université, CHU Nantes, Public Health Department, F-44000 Nantes, France. Electronic address: brigitte.kerivendessomme@chu-nantes.fr., Tack J; Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium; Clinical Research and Translational Unit, Grand Hôpital de Charleroi (GHdC), Charleroi, Belgium. Electronic address: jerome.tack@ulb.be., Rozec B; Nantes Université, CHU Nantes, Department of Anesthesiology and Critical Care, Laënnec Hospital, F-44000 Nantes, France; Nantes Université, CHU Nantes, CNRS, INSERM, l'Institut du Thorax, F-44000 Nantes, France. Electronic address: bertrand.rozec@chu-nantes.fr., Poiroux L; Nursing Department Health Faculty of the University of Angers - Inserm UMR 1085 - Equipe d'épidémiologie en santé au travail et ergonomie (ESTER), France. Electronic address: laurent.poiroux@univ-angers.fr.
Jazyk: angličtina
Zdroj: Intensive & critical care nursing [Intensive Crit Care Nurs] 2024 Oct 30, pp. 103866. Date of Electronic Publication: 2024 Oct 30.
DOI: 10.1016/j.iccn.2024.103866
Abstrakt: Background: Within French intensive care units (ICUs), patients are treated with two levels of care (intensive or intermediate) with different nurse-to-patient ratios legally defined.
Objectives: We aimed to compare the nursing workload associated with these two levels of care.
Research Methodology: A nationwide prospective observational study was conducted in France between April and July 2023. Each ICU was allowed to choose its own two-week period of data collection during which the Nursing Activities Score was collected by nurses at patients' bedside, during each shift. The Nursing Activities Score ranges from 20 to 177% and a 100% score represents a nurse per shift. The number of patients per nurse was collected and the Nursing Activities Score per nurse was assessed.
Results: One hundred and five ICUs participated. Overall, 21,665 measurements of Nursing Activities Score per patient and 9,885 Nursing Activities Score per nurse were collected. ICUs were composed by 2083 beds distributed into 1520 (73 %) intensive care beds and 563 (27 %) intermediate care beds. Among the participating units, 93 (89 %) of the teams worked in 2 shifts. Median [p25-p75] Nursing Activities Score per adult patient was 61 % [49-80] for intensive care patients and 47 % [38-61] for intermediate care patients (p < 0.001). Median Nursing Activities Score per nurse for adult population was 127 % [92-167], 143 % [92-198], and 164 % [126-213] for nurses only providing intensive care, only intermediate care or both levels of care, respectively (p < 0.001). A Nursing Activities Score per nurse value >100 % was observed in 71.4 %.
Conclusions: Nurses' workload was high in the ICU, especially when providing intermediate or mixed levels of care.
Implications for Practice: In order to reduce nurses' workload, a review of the nurse-to-patient ratios is expected. Physically separating the two levels of care may be a valuable option.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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