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Alsdurf H, Benedetti A, Buu TN, Adjobimey M, Cook VJ, Fisher D, Fox G, Fregonese F, Hadisoemarto P, Johnston J, Long R, Obeng J, Oxlade O, Ruslami R, Schwartzman K, Strumpf E, Menzies D. Human resource implications of expanding latent tuberculosis patient care activities. Front Med (Lausanne) 2024; 10:1265476. [PMID: 38283039 PMCID: PMC10811144 DOI: 10.3389/fmed.2023.1265476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 12/26/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction The World Health Organization (WHO) declared increasing services for latent tuberculosis infection (LTBI) a priority to eliminate tuberculosis (TB) by 2035. Yet, there is little information about thehuman resource needs required to implement LTBI treatment scale-up. Our study aimed to estimate the change in healthcare workers (HCW) time spent on different patient care activities, following an intervention to strengthen LTBI services. Methods We conducted a time and motion (TAM) study, observing HCW throughout a typical workday before and after the intervention (Evaluation and Strengthening phases, respectively) at 24 health facilities in five countries. The precise time spent on pre-specified categories of work activities was recorded. Time spent on direct patient care was subcategorized as relating to one of three conditions: LTBI, active or suspected TB, and non-TB (i.e., patients with any other medical condition). A linear mixed model (LMM) was fit to estimate the change in HCW time following the intervention. Results A total of 140 and 143 HCW participated in the TAMs during the Evaluation and Strengthening phases, respectively. Results from intervention facilities showed an increase of 9% (95% CI: 3%, 15%) in the proportion of HCW time spent on LTBI-related services, but with a corresponding change of -11% (95% CI: -21%, -1%) on active TB services. There was no change in the proportion of time spent on LTBI care in control facilities; this remained low in both phases of the study. Discussion Our findings suggest that additional HCW personnel will be required for expansion of LTBI services to ensure that this expansion does not reduce the time available for care of active TB patients.
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Affiliation(s)
- Hannah Alsdurf
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
- McGill International TB Centre, McGill University, Montreal, QC, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
- McGill International TB Centre, McGill University, Montreal, QC, Canada
| | - Tran Ngoc Buu
- Woolcock Institute of Medical Research, Hanoi, Vietnam
| | - Menonli Adjobimey
- Programme National Contre la Tuberculose, Centre National Hospitalier Universitaire de Pneumo-Phtisiologie, Cotonou, Benin
| | - Victoria J. Cook
- Provincial Tuberculosis Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Dina Fisher
- Division of Respiratory Medicine, University of Calgary, Calgary, AB, Canada
| | - Gregory Fox
- The University of Sydney Central Clinical School, The Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | | | - Panji Hadisoemarto
- Department of Public Health, Faculty of Medicine, TB-HIV Research Center, Universitas Padjadjaran, Bandung, Indonesia
| | - James Johnston
- Provincial Tuberculosis Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Richard Long
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Joseph Obeng
- Chest Clinic, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Olivia Oxlade
- McGill International TB Centre, McGill University, Montreal, QC, Canada
- Respiratory Epidemiology and Clinical Research Unit (RECRU), McGill University, Montreal, QC, Canada
| | - Rovina Ruslami
- Department of Biomedical Sciences, Division of Pharmacology and Therapy, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Kevin Schwartzman
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
- McGill International TB Centre, McGill University, Montreal, QC, Canada
- Respiratory Epidemiology and Clinical Research Unit (RECRU), McGill University, Montreal, QC, Canada
| | - Erin Strumpf
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Dick Menzies
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
- McGill International TB Centre, McGill University, Montreal, QC, Canada
- Respiratory Epidemiology and Clinical Research Unit (RECRU), McGill University, Montreal, QC, Canada
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Miller M, Hemberg J. Nurse leaders' perceptions of workload and task distribution in public healthcare: A qualitative explorative study. J Clin Nurs 2022. [PMID: 35773960 DOI: 10.1111/jocn.16428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/20/2021] [Accepted: 06/10/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Unreasonable workload and work-related stress can reduce nurse leaders' job satisfaction and productivity and can increase absence and burnout. Nurse leaders' workload in public healthcare settings is relatively unresearched. THE AIM The aim of this study was to investigate nurse leaders' perceptions of workload and task distribution with relation to leading work tasks in public healthcare. RESEARCH DESIGN, PARTICIPANTS AND RESEARCH CONTEXT A qualitative explorative design was used. The data material consisted of texts from interviews with nurse leaders in public healthcare (N = 8). The method was inspired by content analysis. The COREQ checklist was used. ETHICAL CONSIDERATIONS Informed consent was sought from the participants regarding study participation and the storage and handling of data for research purposes. FINDINGS Six main themes were found: Increased and unreasonable workload, Length of work experience as nurse leader affects perception of workload, Number of staff and staff characteristics affect perception of workload, Versatile and flexible task distribution, Working overtime as a way of managing high workload and Insufficient time for leadership mission. CONCLUSION The workload for nurse leaders in a public healthcare setting was perceived to be unreasonable. Common measures for managing high workload included working overtime, delegating work tasks and organising more staff resources in the form of additional staff. How nurse leaders perceive their workload was linked to both the number of staff and staff characteristics. These should both be considered equally important when determining staff levels and measuring nurse leaders' workload. Future research should focus on investigating workload and task distribution from nurses' perspectives. RELEVANCE TO CLINICAL PRACTICE Through this study, greater understanding of workload and the diverse work of nurse leaders in a public healthcare setting has been revealed, which can be used to further develop the framework for nurse leaders' work.
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Affiliation(s)
| | - Jessica Hemberg
- Department of Caring Sciences, Faculty of Education and Welfare Studies, Åbo Akademi University, Vasa, Finland
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Banda Z, Simbota M, Mula C. Nurses’ perceptions on the effects of high nursing workload on patient care in an intensive care unit of a referral hospital in Malawi: a qualitative study. BMC Nurs 2022; 21:136. [PMID: 35650646 PMCID: PMC9158292 DOI: 10.1186/s12912-022-00918-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 05/24/2022] [Indexed: 11/16/2022] Open
Abstract
Background The Malawi health system has taken numerous actions to reduce high nurse workloads, despite this, shortage of nurses especially in critical care settings still persists due to lack of prioritisation of critical care. Therefore, it is important to understand the effects of high nursing workload in Intensive Care Unit (ICU). This study aimed at exploring the perceptions of nurses regarding the effects of high nursing workload on patient care in ICU at Queen Elizabeth Central Hospital. Methods This qualitative descriptive study was conducted in a general ICU at Queen Elizabeth Central Hospital in Blantyre, Malawi. A purposive sample of 12 nurses working in the ICU was selected. Participants included full-time nurses working in the ICU. A total of 10 In-depth interviews were conducted to collect data upon which data saturation was reached. A semi-structured interview guide was used for data collection. Data was analysed manually using thematic analysis method by Braun & Clarke. Results Study findings indicated that high nursing workload compromises the delivery of quality nursing care to critically ill patients, compromises patient safety and has negative impact on nurses’ wellbeing. Conclusion The study findings portray that nurses are aware of the negative effects that high nursing workload has on patient care. The study findings support the need for more ICU nurses in order to reduce nurse workloads and the need for nurse managers and policy makers to develop strategies to manage nurse workloads and its effects on patient care.
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Bingham G, Tong E, Poole S, Ross P, Dooley M. A longitudinal time and motion study quantifying how implementation of an electronic medical record influences hospital nurses' care delivery. Int J Med Inform 2021; 153:104537. [PMID: 34343955 DOI: 10.1016/j.ijmedinf.2021.104537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/11/2021] [Accepted: 07/18/2021] [Indexed: 10/20/2022]
Abstract
AIM BACKGROUND Many health care services are implementing or planning to undergo digital transformation to keep pace with increasing Electronic Medical Record (EMR) functionality. The aim of this study was to objectively measure nursing care delivery before and following introduction of an EMR. DESIGN AND METHODS An extensive program of work to expand an EMR across our health service using a 'big bang' methodology was undertaken. The program incorporated digital care delivery workflows including physiological observations, clinical notes and closed loop medication management. The validated Work Observation Method by Activity Timing (WOMBAT) method was applied to undertake a direct observational time and motion study of nurses' work in a major Australian hospital immediately prior to and six months following the introduction of a full clinical EMR. RESULTS Time and motion results were from observing approximately one week of nursing time pre (paper) to six months post (EMR) implementation. A non-significant 6.4% increase in the proportion of time spent on direct care was observed when using the EMR with a statistically significant increase in mean time per direct care task (2.5 min vs 3.9 min, p = 0.001). The proportion of time spent on medication-related activities did not significantly change although the average time per task rose from 2.0 to 2.9 min (p = 0.008). A significant reduction in proportion of time spent in transit and indirect care tasks when using the electronic workflows was reported. No statistically significant changes to the proportions of time spent on professional communication, direct care or documentation were observed. CONCLUSIONS Successful EMR implementation is possible without adversely affecting allocation of nursing time. Our findings from deploying a large scale EMR across all healthcare craft groups and workflows have described for nurses that an EMR enables them to spend longer with patients per direct care episode and use their time on other activities more effectively.
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Affiliation(s)
| | - Erica Tong
- Department of Pharmacy, Alfred Health, Australia
| | - Susan Poole
- Department of Pharmacy, Alfred Health, Australia
| | - Paul Ross
- Intensive Care Unit, Alfred Health, Australia
| | - Michael Dooley
- Department of Pharmacy, Alfred Health, Australia; Monash University, Centre for Medication Use and Safety, Australia
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Redley B, Douglas T, Botti M. Methods used to examine technology in relation to the quality of nursing work in acute care: A systematic integrative review. J Clin Nurs 2020; 29:1477-1487. [PMID: 32045059 DOI: 10.1111/jocn.15213] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/09/2020] [Accepted: 02/03/2020] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To systematically locate, assess and synthesise research to describe methods used to examine technology in relation to the quality of nursing work in acute care. Specific objectives were to (a) describe the types of nursing work examined; (b) describe methods used to examine technology in nursing work; (c) identify outcomes used to evaluate technology in relation to the quality of nursing work; and (d) make recommendations for future research. BACKGROUND New technologies can offer numerous benefits to nurses; however, it is challenging to evaluate health information technologies in relation to the quality of nurses' complex day-to-day work. DESIGN A systematic integrative review using a five-step process. METHODS Five databases were searched using search terms "nurs*," "workload," "task," "time." Data screening, extraction and interpretation were conducted independently by at least two authors and agreement verified by discussion. Data extraction followed PRISMA guidelines. RESULTS Of the 41 studies included, most (87.8%, n = 36) examined physical dimensions of nursing work; 31.7% (n = 13) organisational dimensions; 17.1% (n = 8) cognitive dimensions; and only 12.2% (n = 5) emotional dimensions. More than half (58.5%, n = 24) examined only one dimension; one captured all four dimensions. Most frequently examined technologies were electronic medical/health records (36.5%) and electronic medication management (19.5%). Direct observation (58.8%, n = 28) and multiple methods (19.5%, n = 8) were the most common methods; nurse tasks, frequency, duration and time distribution were variables most often measured. CONCLUSIONS Examinations of technology in nursing work often failed to capture the multiple dimensions of this work nor did they recognise the complexity of day-to-day nursing work in acute care. There is a paucity of literature to inform how and what technology should be measured in relation to the quality of nursing care. RELEVANCE TO CLINICAL PRACTICE The outcomes inform useful research methods to comprehensively examine technology to enhance the quality of complex nursing work.
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Affiliation(s)
- Bernice Redley
- Centre for Quality and Patient Safety Research - Monash Health Partnership, School of Nursing and Midwifery, Deakin University, Burwood, Vic., Australia
| | - Tracy Douglas
- School of Nursing and Midwifery, Deakin University, Burwood, Vic., Australia
| | - Mari Botti
- Centre for Quality and Patient Safety Research - Epworth Healthcare Partnership, School of Nursing and Midwifery, Deakin University, Burwood, Vic., Australia
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Fitriani R, Yetti K, Kuntarti K. Analysis of workload and occupational commitment: Their relationship to the caring behaviors of nurses in a hospital. ENFERMERIA CLINICA 2019. [DOI: 10.1016/j.enfcli.2019.04.097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Pompermaier L, Elmasry M, Abdelrahman I, Fredrikson M, Sjöberg F, Steinvall I. Are there any differences in the provided burn care between men and women? A retrospective study. BURNS & TRAUMA 2018; 6:22. [PMID: 30123802 PMCID: PMC6088398 DOI: 10.1186/s41038-018-0125-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 07/13/2018] [Indexed: 12/22/2022]
Abstract
Background Disparity between medical treatment for men and women has been recorded worldwide. However, it is difficult to find out if the disparities in both the use of resources and outcome depend entirely on sex-related discrimination. Our aim was to investigate if there are differences in burn treatments between the sexes. Methods All patients admitted with burns to Linköping University Hospital during the 16-year period 2000–2015 were included. Interventions were prospectively recorded using the validated Burn SCoring system (BSC). Data were analysed using a multivariable panel regression model adjusted for age, percentage total body surface area (%TBSA), and in-hospital mortality. Results A total of 1363 patients were included, who generated a total of 22,301 daily recordings while they were inpatients. Males were 70% (930/1363). Sex was not an independent factor for daily scores after adjustment for age, %TBSA, and mortality in hospital (model R2=0.60, p < 0.001). Conclusion We found no evidence of inequity between the sexes in treatments given in our burn centre when we had adjusted for size of burn, age, and mortality. BSC seems to be an appropriate model in which to evaluate sex-related differences in the delivery of treatments.
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Affiliation(s)
- Laura Pompermaier
- 1Department of Plastic Surgery, Hand Surgery, and Burns, Linköping University, Linköping, Sweden.,2Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.,5the Burn Centre, Linköping University Hospital, 58185 Linköping, Sweden
| | - Moustafa Elmasry
- 1Department of Plastic Surgery, Hand Surgery, and Burns, Linköping University, Linköping, Sweden.,2Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Islam Abdelrahman
- 2Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.,3Department of Surgery, Plastic Surgery Unit, Suez Canal University, Ismailia, Egypt
| | - Mats Fredrikson
- 2Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Folke Sjöberg
- 1Department of Plastic Surgery, Hand Surgery, and Burns, Linköping University, Linköping, Sweden.,2Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.,4Department of Anaesthesia and Intensive Care, Linköping University, Linköping, Sweden
| | - Ingrid Steinvall
- 1Department of Plastic Surgery, Hand Surgery, and Burns, Linköping University, Linköping, Sweden.,2Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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Baumann LA, Baker J, Elshaug AG. The impact of electronic health record systems on clinical documentation times: A systematic review. Health Policy 2018; 122:827-836. [PMID: 29895467 DOI: 10.1016/j.healthpol.2018.05.014] [Citation(s) in RCA: 128] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 05/23/2018] [Accepted: 05/25/2018] [Indexed: 10/14/2022]
Abstract
BACKGROUND Effective management of hospital staff time is crucial to quality patient care. Recent years have seen widespread implementation of electronic health record (EHR) systems but the effect of this on documentation time is unknown. This review compares time spent on documentation tasks by hospital staff (physicians, nurses and interns) before and after EHR implementation. METHODS A systematic search identified 8153 potentially relevant citations. Studies examining proportion of total workload spent on documentation with ≥40 h of staff observation time were included. Meta-analysis was performed for physicians, nurses and interns comparing pre- and post-EHR results. Studies were weighted by person-hours observation time. RESULTS Twenty-eight studies met selection criteria. Seventeen were pre-EHR, nine post-EHR and two examined both periods. With implementation of EHR, physicians' documentation time increased from 16% (95% confidence interval (CI) 11-22%) to 28% (95% CI 19-37%), nurses from 9% (95% CI 6-12%) to 23% (95% CI 15-32%) and interns from 20% (95% CI 7-32%) to 26% (95% CI 10-42%). CONCLUSIONS There is a lack of long-term follow-up on the effects of EHR implementation. Initial adjustment to EHR appears to increase documentation time but there is some evidence that as staff become more familiar with the system, it may ultimately improve work flow.
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Affiliation(s)
- Lisa Ann Baumann
- University of Bremen, University of Bremen, Bibliothekstraße 1, 28359, Bremen, Germany.
| | - Jannah Baker
- Menzies Centre for Health Policy, Sydney School of Public Health, The University of Sydney, NSW 2006, Australia.
| | - Adam G Elshaug
- Menzies Centre for Health Policy, Sydney School of Public Health, The University of Sydney, NSW 2006, Australia.
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Validation of the burn intervention score in a National Burn Centre. Burns 2018; 44:1159-1166. [PMID: 29475745 DOI: 10.1016/j.burns.2018.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 01/11/2018] [Accepted: 02/02/2018] [Indexed: 11/20/2022]
Abstract
The Linköping burn score has been used for two decades to calculate the cost to the hospital of each burned patient. Our aim was to validate the Burn Score in a dedicated Burn Centre by analysing the associations with burn-specific factors: percentage of total body surface area burned (TBSA%), cause of injury, patients referred from other (non-specialist) centres, and survival, to find out which of these factors resulted in higher scores. Our second aim was to analyse the variation in scores of each category of care (surveillance, respiration, circulation, wound care, mobilisation, laboratory tests, infusions, and operation). We made a retrospective analysis of all burned patients admitted during the period 2000-15. Multivariable regression models were used to analyse predictive factors for an increased daily burn score, the cumulative burn score (the sum of the daily burn scores for each patient) and the total burn score (total sum of burn scores for the whole group throughout the study period) in addition to sub-analysis of the different categories of care that make up the burn score. We retrieved 22301 daily recordings for inpatients. Mobilisation and care of the wound accounted for more than half of the total burn score during the study. Increased TBSA% and age over 45 years were associated with increased cumulative (model R2 0.43, p<0.001) and daily (model R2 0.61, p<0.001) burn scores. Patients who died had higher daily burn scores, while the cumulative burn score decreased with shorter duration of hospital stay (p<0.001). To our knowledge this is the first long term analysis and validation of a system for scoring burn interventions in patients with burns that explores its association with the factors important for outcome. Calculations of costs are based on the score, and it provides an indicator of the nurses' workload. It also gives important information about the different dimensions of the care provided from thorough investigation of the scores for each category.
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Schenk E, Schleyer R, Jones CR, Fincham S, Daratha KB, Monsen KA. Time motion analysis of nursing work in ICU, telemetry and medical-surgical units. J Nurs Manag 2017; 25:640-646. [DOI: 10.1111/jonm.12502] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Elizabeth Schenk
- College of Nursing; Washington State University; Spokane Washington USA
| | - Ruth Schleyer
- Informatics; Academics & Education; Providence Health & Services; Renton Washington USA
| | - Cami R. Jones
- College of Nursing; Washington State University; Spokane Washington USA
| | - Sarah Fincham
- College of Nursing; Washington State University; Spokane Washington USA
| | - Kenn B. Daratha
- College of Nursing; Washington State University; Spokane Washington USA
| | - Karen A. Monsen
- Center for Nursing Informatics; School of Nursing; University of Minnesota; Minneapolis Minnesota USA
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Nogueira LDS, Padilha KG, Silva DV, Lança EDFC, Oliveira EMD, Sousa RMCD. Padrão de intervenções de enfermagem realizadas em vítimas de trauma segundo o Nursing Activities Score. Rev Esc Enferm USP 2015; 49 Spec No:29-35. [DOI: 10.1590/s0080-623420150000700005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 07/13/2015] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo Identificar o padrão de intervenções de enfermagem realizadas em vítimas de trauma nas primeiras 24 horas de internação na Unidade de Terapia Intensiva (UTI). Método Estudo prospectivo, realizado na UTI de um hospital em São Paulo, Brasil. O instrumento Nursing Activities Score (NAS) foi utilizado para identificar as intervenções de enfermagem. Resultados A casuística foi composta por 200 pacientes, a maioria homens, com idade média de 40,7 anos, vítimas de acidentes de transporte. A média do NAS foi de 71,3% e o padrão de intervenções de enfermagem identificado incluiu as atividades de monitorização e controles; investigações laboratoriais; medicação, exceto drogas vasoativas; procedimentos de higiene; cuidados com drenos; mobilização e posicionamento; suporte e cuidado aos familiares e pacientes; tarefas administrativas e gerenciais; suporte respiratório; cuidado com vias aéreas artificiais; e tratamento para melhora da função pulmonar. Nas intervenções de monitorização e mobilização, houve a necessidade de cuidados além do normalmente requerido por pacientes de UTI. Conclusão Os resultados desta pesquisa trazem importantes contribuições para o planejamento de ações que visem a capacitação e o dimensionamento da equipe de enfermagem na unidade crítica.
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