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Cruz López LN, Quintero Osorio JF, Melo Roa JD, Henao Castaño ÁM. Carga laboral de profesionales de enfermería en Unidad de Cuidado Intensivo según Nursing Activities Score. REVISTA CUIDARTE 2023. [DOI: 10.15649/cuidarte.2680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
Highlights:
La NAS es una herramienta que toma relevancia al momento de evaluar la carga de trabajo de los profesionales de enfermería.
Se evidencia que el personal de enfermería está expuesto a altas cargas de trabajo que, en la mayoría de casos, supera lo sugerido por Consejos y Asociaciones de enfermería.
Algunos factores que pueden afectar la carga de trabajo son el tipo de turnos de trabajo, sexo del profesional, tipo de UCI, el número de pacientes a cargo, entre otros.
Es necesario evaluar la implementación de la NAS en distintos tipos de servicios para entender la situación y trabajo actual de los profesionales de enfermería.
Introducción: Nursing Activities Score ha sido utilizada como un instrumento principalmente en la Unidad de Cuidados Intensivos para medir las actividades de enfermería, siendo esta la unidad que maneja pacientes de mayor complejidad para el cuidado. Objetivo: establecer la carga de trabajo, evaluada por Nursing Activities Score, y factores relacionados a la misma en Unidades de Cuidado Intensivo. Metodología: Revisión cualitativa tipo scoping Review, utilizando el método PRISMA. Búsqueda en las bases de datos CINAHL, LILACS, SCOPUS, SCIENCE DIRECT, SCIELO y PUBMED. Resultados: La muestra final se compone de 87 textos, que van desde el año 2007 hasta 2021. Se clasificaron en cinco categorías: Carga de trabajo en UCI, comparación entre unidades, carga de trabajo relacionada al personal de enfermería, carga de trabajo relacionada a las características de los pacientes y consecuencias de la carga de trabajo. Discusión: La revisión revela una carga de trabajo mayor al 50% en la mayoría de los estudios, esto debido a diferentes factores: principalmente las características particulares de los pacientes, no se observó una diferencia significativa entre unidades generales y especializadas, las cargas de trabajo elevadas suponen un factor de riesgo para la ocurrencia de eventos adversos. Conclusiones: Los resultados de esta revisión permiten evidenciar que el personal de enfermería está expuesto constantemente a altas cargas de trabajo. Esta carga de trabajo puede verse influenciada o influenciar diversos factores, como lo son las características de los pacientes a quienes se brinda atención o puede afectar positiva o negativamente la calidad de la atención de enfermería.
Como citar este artículo: Cruz López Laura Nathalie, Quintero Osorio Jenny Fernanda, Melo Roa Juan David, Henao Castaño Ángela María. Carga laboral de profesionales de enfermería en Unidad de Cuidado Intensivo según Nursing Activities Score. Revista Cuidarte. 2023;14(1):e2680. http://dx.doi.org/10.15649/cuidarte.2680
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da Silva RL, da Silva LB, Silva ANA. Relationship between mental workload and hospital infection in the ICU. Work 2022; 73:915-925. [DOI: 10.3233/wor-205266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Nursing is among the most stressful professions. Studies that examine possible factors that influence the mental workload (MWL) of nurses are of fundamental importance, because through these results, efforts can be concentrated on improving their working conditions more efficiently. OBJECTIVE: To investigate the influence of hospital infection on the MWL of nurses in an intensive care unit (ICU). METHOD: Cross-sectional and descriptive study, with a quantitative approach. Three research instruments were used: a sociodemographic questionnaire, the NASA Task Load Index (NASA-TLX) and the Nursing Work Index-Revised Brazilian version (B-NWI-R). The sample consisted of 30 nurses from the ICU of a public hospital in João Pessoa city, Brazil, during the daytime period, and the Spearman correlation test (α= 0,05) was applied to verify associations. RESULTS: There was a high MWL among nurses, with a NASA-TLX weighted average of 66.38 (SD±15.0). Correlations were found between the levels of hospital infection in the ICU and the MWL of the nurses (r = 0.654, p < 0.01); in the nurses’ care of patients with urinary tract infection, the correlation is 0.546, p < 0.01; if care is provided to patients with lung problems, the correlation is 0.563, p < 0.01 The ICU presented a favorable environment to nursing practices, with means lower than 2.5, according to the B-NWI-R. CONCLUSION: The MWL of the nurses was associated with the hospital infection levels of the intensive care sector studied. It was found that the MWL of nurses in relation to hospital infection in the ICU increased by 42.8% . This MWL is impacted by 29.8% when nurses’ care is linked to patients with urinary infection. But if care is provided to patients with lung problems, this percentage rises to 31.7%
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Affiliation(s)
- Ravenna Leite da Silva
- Postgraduate Program in Production Engineering, Federal University of Paraiba (UFPB), João Pessoa, Paraíba, Brazil
| | - Luiz Bueno da Silva
- Department of Production Engineering, Postgraduate Program in Civil and Environmental Engineering, Federal University of Paraiba (UFPB), João Pessoa, Paraíba, Brazil
| | - Aryelle Nayra Azevedo Silva
- Postgraduate Program in Civil and Environmental Engineering, Federal University of Paraiba (UFPB), João Pessoa, Paraíba, Brazil
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Azevedo AV, Tonietto TA, Boniatti MM. Nursing workload on the day of discharge from the intensive care unit is associated with readmission. Intensive Crit Care Nurs 2021; 69:103162. [PMID: 34895796 DOI: 10.1016/j.iccn.2021.103162] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/02/2021] [Accepted: 09/23/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE To verify whether there is an association between the Nursing Activities Score (NAS) on the day of discharge from the intensive care unit and readmission.. MATERIALS AND METHODS A retrospective cohort study of all patients admitted to the intensive care unit of Hospital Ernesto Dornelles, Porto Alegre, Brazil, who were discharged to the ward from October 2018 to December 2019. We collected demographic and clinical variables of the patients and the Nursing Activities Scoreon the day of discharge. Patients were followed up until the day of hospital discharge or death. RESULTS We included 1045 patients in the final sample. One hundred eighty-eight (18.0%) patients were readmitted, in addition there were two (0.2%) unexpected deaths that occurred in the ward. The median NAS was 59.9 (50.9-67.3), which was higher in the bivariate analysis in patients who were readmitted (64.0, 55.7-71.4) than in patients who were not readmitted (58.7, 49.7-66.1) (p < 0.001). Patients with a Nursing Activities Score ≥ 60.0 and < 60.0 had rates of readmission of 23.4% and 12.7%, respectively (p < 0.001). After multivariable adjustment, the Nursing Activities Score at discharge maintained an association with readmission. In addition, in the Cox regression, the Nursing Activities Score as a dichotomous variable was independently associated with readmission (adjusted HR 1.560; CI 1.146-2.125; p = 0.005). CONCLUSIONS We found that the nursing workload, assessed by the Nursing Activities Score at the time of discharge from the intensive care unit, was associated with risk of readmission..
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Affiliation(s)
| | - Tiago A Tonietto
- Critical Care Department, Hospital de Clínicas de Porto Alegre, Brazil
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Paiva RDM, Ferreira LDL, Bezerril MDS, Chiavone FTB, Salvador PTCDO, Santos VEP. Infection factors related to nursing procedures in Intensive Care Units: a scoping review. Rev Bras Enferm 2021; 74:e20200731. [PMID: 33886931 DOI: 10.1590/0034-7167-2020-0731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 10/03/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to identify and map the invasive procedures performed by nursing that can cause Healthcare-Associated Infections in patients in Intensive Care Units. METHODS this is a scoping review carried out in the first half of 2018, based on search for studies in national and international databases, in which 2,209 studies were found, of which 35 constituted the final sample. The data were analyzed and organized by simple descriptive statistics. RESULTS among the invasive procedures performed by nursing that provide Healthcare-Associated Infections, delayed bladder catheter was indicated in 34 (66.67%) studies, the nasogastric catheter in 10 (19.61%) and the nasoenteral catheter in two (03.92%). CONCLUSIONS in the face of such problems, better nursing planning and guidance for care in these invasive techniques becomes relevant and thus minimizes the incidence of infections.
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Abstract
Nursing work efforts are important in providing sound healthcare services, especially in the intensive care units (ICU). Complications and adverse events are more liable to occur among patients in the ICU and these patients require more attention and nursing care. Most of the research in this field is mainly focused on the effect of staffing and its correlation to patient safety and satisfaction. Previous studies also showed that reduced nursing staffing was significantly associated with the development of pneumonia in ICU patients who needed more nursing requirements. An increase in nursing workload is also significantly associated with an increased incidence rate of nosocomial infections. The association between nursing workload in ICU patients and increased incidence rates of mortality is also supported by previous studies. The nurse-to-patient ratio has been previously used to evaluate patient safety correlation with the nursing workload as reported by previous reports. However, previous research shows that the nursing workload is a more complex correlation and can not be determined by a simple ratio as the nurse-to-patient one. Evidence shows that many adverse events may occur with patients in the ICU secondary to reduced nursing care such as increased mortality, length of hospital stay, and catching in-hospital infections. In the current study, we aim to review the outcomes from previous investigations to further emphasize the effect of nursing workload on ICU patient outcomes and safety.
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Ferreira LDL, Azevedo LMND, Salvador PTCDO, Morais SHMD, Paiva RDM, Santos VEP. Nursing Care in Healthcare-Associated Infections: A Scoping Review. Rev Bras Enferm 2019; 72:476-483. [PMID: 31017213 DOI: 10.1590/0034-7167-2018-0418] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 08/08/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To identify and map nursing care to the adult patient with Healthcare-Associated Infections admitted to the Intensive Care Unit. METHOD Scoping Review, conducted in January 2018, through the search of studies in national and international databases, journals, catalogs of theses and dissertations, and websites of Brazilian health institutions. We included full surveys published in the Portuguese, Spanish or English language; which had as object of study the researched subject, besides manuals and protocols. We analyzed the type of material, year, country, population, method, Level of Evidence, and nursing care. The final sample consisted of 33 publications. RESULTS Among the nursing care to the patient, hand hygiene was identified, general care in nursing procedures, use of protocols, effective communication and periodic training. CONCLUSION Identifying patient care with infection was important in order to list methods and reorient nursing activities.
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Cyrino CMS, Dell'Acqua MCQ, Castro MCNE, Oliveira EMD, Deodato S, Almeida PMVD. Nursing Activities Score by assistance sites in Intensive Care Units. ESCOLA ANNA NERY 2017. [DOI: 10.1590/2177-9465-ean-2017-0145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: To compare the Nursing Activities Score (NAS) between the Assistance Sites in an Intensive Care Unit. Method: Descriptive, retrospective study, carried out in the Intensive Care Unit of a teaching hospital. The patients were organized in Assistance Sites according to their clinical characteristics and the nursing team's composition was organized in accordance with the Nursing Activities Score (NAS). The confidence interval was set at p < 0.05. Results: the majority were male surgical patients with a mean age of 56.8 years. The postoperative care Site presented the greatest patient turnover. The overall average NAS was 71.7%. There was a difference in the nursing workload between the different Assistance Sites. The shorter length of stay and the nonsurvivors contributed to increasing the workload in the ICU. Conclusion: Comparing the NAS in the different Sites made it possible to organize the work process of the nursing team according to each group, contributing to patient safety.
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Nogueira TDA, Menegueti MG, Perdoná GDSC, Auxiliadora-Martins M, Fugulin FMT, Laus AM. Effect of nursing care hours on the outcomes of Intensive Care assistance. PLoS One 2017; 12:e0188241. [PMID: 29190742 PMCID: PMC5708759 DOI: 10.1371/journal.pone.0188241] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Accepted: 11/05/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To correlate the average number of nursing care hours dedicated to Intensive Care Unit (ICU) patients with nursing care indicators. METHOD Transverse, descriptive study conducted between 2011 and 2013. Data were obtained from the electronic records system and from the nursing staff daily schedule. Generalized Linear Models were used for analysis. RESULTS A total of 1,717 patients were included in the study. The average NAS (Nursing Activities Score) value was 54.87. The average ratio between the number of nursing care hours provided to the patient and the number of nursing care hours required by the patient (hours ratio) was 0.87. Analysis of the correlation between nursing care indicators and the hours ratio showed that the indicators phlebitis and ventilator-associated pneumonia significantly correlated with hours ratio; that is, the higher the hours ratio, the lower the incidence of phlebitis and ventilator-associated pneumonia. CONCLUSION The number of nursing care hours directly impacts patient outcomes, which makes adjustment of nurse staffing levels essential.
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Affiliation(s)
- Tatiana do Altíssimo Nogueira
- Department of Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Mayra Gonçalves Menegueti
- Department of Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Gleice da Silva Castro Perdoná
- Department of Social Medicine, University of São Paulo at Ribeirão Preto Faculty of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Maria Auxiliadora-Martins
- Department of Surgery and Anatomy, Division of Intensive Care University of São Paulo at Ribeirão Preto Faculty of Medicine, Ribeirão Preto, São Paulo, Brazil
| | | | - Ana Maria Laus
- Department of Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
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Padilha KG, Barbosa RL, Andolhe R, Oliveira EMD, Ducci AJ, Bregalda RS, Secco LMD. CARGA DE TRABALHO DE ENFERMAGEM, ESTRESSE/BURNOUT, SATISFAÇÃO E INCIDENTES EM UNIDADE DE TERAPIA INTENSIVA DE TRAUMA. TEXTO & CONTEXTO ENFERMAGEM 2017. [DOI: 10.1590/0104-07072017001720016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: analisar a influência da carga trabalho, estresse, Burnout, satisfação e percepção do ambiente de cuidado, pela equipe de enfermagem com a presença de eventos adversos em Unidade de Terapia Intensiva de Trauma. Método: estudo observacional realizado em Unidade de Terapia Intensiva de Trauma. Para a coleta de incidentes foram acompanhados 195 pacientes, prospectivamente, sendo utilizados instrumentos para medir a carga de trabalho de enfermagem, estresse, Burnout, satisfação no trabalho e trabalho de avaliação do ambiente laboral pela equipe de enfermagem. Os dados foram analisados por meio de análise estatística. Resultados: ocorreram 1.586 incidentes, predominantemente incidentes sem dano (78,44%). Entre a equipe de enfermagem, 77,40% tinham níveis médios de estresse; 17,00% apresentaram Burnout; 56,6% estavam insatisfeitos e consideraram as características ambientais inadequadas. A carga de trabalho de enfermagem foi alta (73,24%). Houve associação entre incidentes e tempo de permanência. Os incidentes sem dano tiveram associação com a carga de trabalho de enfermagem. Conclusão: a identificação de fatores associados pode prevenir a ocorrência de incidentes.
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Nazario EG, Camponogara S, Dias GL. Riscos ocupacionais e adesão a precauções-padrão no trabalho de enfermagem em terapia intensiva: percepções de trabalhadores. REVISTA BRASILEIRA DE SAÚDE OCUPACIONAL 2017. [DOI: 10.1590/2317-6369000009216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Introdução: o trabalho em unidades de terapia intensiva proporciona grande exposição a riscos ocupacionais. Objetivos: conhecer a percepção de trabalhadores de enfermagem de terapia intensiva sobre os riscos ocupacionais a que estão expostos e sobre as Precauções-Padrão (PP) e descrever os fatores que interferem, ou não, na adesão às PP recomendadas. Método: estudo de abordagem qualitativa, descritivo exploratório, com doze trabalhadores de enfermagem de duas unidades de terapia intensiva, realizado entre julho e setembro de 2015. Foi utilizada entrevista semiestruturada e análise de conteúdo temática. Resultados: os riscos psicológicos ou emocionais, químicos, biológicos e ergonômicos foram os mais percebidos. Em relação às PP, os trabalhadores indicam que existe adesão, mas não integralmente, principalmente no uso de EPIs. Identificaram-se como fatores favoráveis à adesão das PP a disponibilização de materiais de proteção e a conscientização e, como desfavoráveis, sentimento de autoconfiança, estrutura das unidades e organização do trabalho, quantitativo de funcionários, carga de trabalho, pressa, intercorrências e tempo prolongado para diagnóstico de pacientes com doenças infectocontagiosas. Conclusão: apesar das questões pessoais envolvidas na percepção dos riscos ocupacionais e na decisão de utilizar ou não as PP, as autoras entendem que é possível potencializar os fatores que favorecem a adesão.
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