Comparison of Nurses’ Workload and Multiple Organ Failure of Patients Hospitalized in the COVID‑19 and Non–COVID‑19 Intensive Care Units

Mohammad Moradi, Lilia de Souza Nogueira, Nasrin Hanifi

Abstract


Background: Measuring nurses’ workload and related factors in intensive care units and reviewing their staffing is very important during COVID‑19. This study aims to compare nurses’ workload and multiple organ failure of patients hospitalized during the COVID‑19 in intensive care units and non–COVID‑19 intensive care units.

Materials and Methods: An observational study was conducted with 768 patients hospitalized in intensive care units and Zanjan City (Iran) intensive care units in 2021. The data were collected using the Nursing Activities Score and the Sequential Organ Failure Assessment. Data analysis was performed by independent t‑test, Chi‑squared (÷2) test, Pearson’s correlation coefficient (r), and Multiple Linear Regression (MLR). The statistical significance level was set at p < 0.05.

Results: NAS in non–COVID‑19 intensive care units 59.90% (10.03) was significantly higher than that of COVID‑19 intensive care units 56.38% (6.67) (p < 0.001). In addition, the SOFA score was higher in the non–COVID‑19 intensive care units 6.98 (3.89) than in COVID‑19 intensive care units 5.62 (3.98) (p < 0.001). The Nursing Activities Score had a positive and statistically significant relationship with the Sequential Organ Failure Assessment in both units, and this relationship was higher in the COVID‑19 intensive care units (r = 0.71). In addition, predictors of NAS were identified as four variables, i.e. consciousness level, SOFA, length of stay, and having an artificial airway (p < 0.05).

Conclusions: Non–COVID‑19 ICUs had higher NAS and SOFA scores in the study. Further investigation is needed to identify additional workload aspects in intensive care units.



Keywords


COVID‑19, intensive care units, multiple organ failure, nurses, workload

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References


Pérez‑Francisco DH, Duarte‑Clíments G, del Rosario‑Melián JM, Gómez‑Salgado J, Romero‑Martín M, Sánchez‑Gómez MB. Influence of workload on primary care nurses’ health and burnout, patients’ safety, and quality of care: Integrative review. Healthcare (Basel) 2020;8:1‑14.

Jansson M, Ohtonen P, Syrjälä H, Ala‑Kokko T. The proportion of understaffing and increased nursing workload are associated with multiple organ failure: A cross‑sectional study. J Adv Nurs 2020;76:2113‑24.

Bruyneel A, Lucchini A, Hoogendoorn M. Impact of COVID‑19 on nursing workload as measured with the Nursing Activities Score in intensive care. Intensive Crit Care Nurs 2022;69:103170.

Coughlan C, Nafde C, Khodatars S, Jeanes AL, Habib S, Donaldson E, et al. COVID‑19: Lessons for junior doctors redeployed to critical care. Postgrad Med J 2021;97:188‑91.

Gualano MR, Sinigaglia T, Lo Moro G, Rousset S, Cremona A, Bert F, et al. The burden of burnout among healthcare professionals of intensive care units and Emergency Departments during the COVID‑19 pandemic: A systematic review. Int J Environ Res Public Health 2021;18:8172.

Pourteimour S, Yaghmaei S, Babamohamadi H. The relationship between mental workload and job performance among Iranian nurses providing care to COVID‑19 patients: A cross‑sectional study. J Nurs Manag 2021;29:1723‑32.

Spuntarelli V, Luciani M, Bentivegna E, Marini V, Falangone F, Conforti G, et al. COVID‑19: Is it just a lung disease? A case‑based review. SN Compr Clin Med 2020;2:1401‑6.

Sauaia A, Moore EE, Johnson JL, Chin TL, Banerjee A, Sperry JL, et al. Temporal trends of postinjury multiple‑organ failure: Still resource intensive, morbid, and lethal. J Trauma Acute Care Surg 2014;76:582‑93.

Baykara N, Gökduman K, Hoşten T, Solak M, Toker K. Comparison of sequential organ failure assessment (SOFA) scoring between nurses and residents. J Anesth 2011;25:839‑44.

Peng L, Mayner L, Wang H. Association between trauma patients’ severity and critical care nursing workload in China. Nurs Health Sci 2014;16:528‑33.

Kraljic S, Zuvic M, Desa K, Blagaic A, Sotosek V, Antoncic D, et al. Evaluation of nurses’ workload in intensive care unit of a tertiary care university hospital in relation to the patients’ severity of illness: A prospective study. Int J Nurs Stud 2017;76:100‑5.

Mhawish HA, Rasheed AM. Staffing critical care with nurses amid the COVID‑19 crisis: Strategies and plans. Int Nurs Rev 2022;69:369‑74.

Hoogendoorn ME, Brinkman S, Bosman RJ, Haringman J, de Keizer NF, Spijkstra JJ. The impact of COVID‑19 on nursing workload and planning of nursing staff on the Intensive Care: A prospective descriptive multicenter study. Int J Nurs Stud 2021;121:104005.

Mohammadi F, Souza Nogueira Ld, Hanifi N, Bahraminejad N. A Comparison of Nursing Activity Score Means for Missed Care Dimensions in Intensive Care Unit Patients. Nursing Forum. 2023;2023:9913092.

Miranda DR, Nap R, de Rijk A, Schaufeli W, Iapichino G; the members of the TISS Working Group. Nursing activities score. Crit Care Med 2003;31:374‑82.

Nieri A‑S, Manousaki K, Kalafati M, Padilha KG, Stafseth SK, Katsoulas T, et al. Validation of the nursing workload scoring systems “Nursing Activities Score” (NAS), and “Therapeutic Intervention Scoring System for Critically Ill Children” (TISS‑C) in a Greek Paediatric Intensive Care Unit. Intensive Crit Care Nurs 2018;48:3‑9.

Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H, et al. The SOFA (Sepsis‑related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis‑Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med 1996;22:707‑10.

Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, Rea TD, Scherag A, et al. Assessment of clinical criteria for sepsis: For the third international consensus definitions for sepsis and septic shock (sepsis‑3). JAMA 2016;315:762‑74.

Fasoi G, Patsiou EC, Stavropoulou A, Kaba E, Papageorgiou D, Toylia G, et al. Assessment of nursing workload as a mortality predictor in intensive care units (ICU) using the nursing activities score (NAS) scale. Int J Environ Res Public Health 2021;18:79.

Padilha K, Stafseth S, Solms D, Hoogendoom M, Monge F, Gomaa O, et al. Nursing Activities Score: An updated guideline for its application in the Intensive Care Unit. Rev Esc Enferm USP 2015;49:131‑7.

Momennasab M, Karimi F, Dehghanrad F, Zarshenas L. Evaluation of nursing workload and efficiency of staff allocation in a trauma intensive care unit. Trauma Mon 2018;23:e58161.

Campagner AOM, Garcia PCR, Piva JP. Use of scores to calculate the nursing workload in a pediatric intensive care unit. Rev Bras Ter Intensiva 2014;26:36‑43.

Camuci MB, Martins JT, Cardeli AAM, Robazzi MLDCC. Nursing Activities Score: Nursing work load in a burns Intensive Care Unit. Rev Lat Am Enfermagem 2014;22:325‑31.

Reper P, Bombart MA, Leonard I, Payen B, Darquennes O, Labrique S. Nursing Activities Score is increased in COVID‑19 patients. Intensive Crit Care Nurs 2020;60:102891.

Pfortmueller CA, Spinetti T, Urman RD, Luedi MM, Schefold JC. COVID‑19‑associated acute respiratory distress syndrome (CARDS): Current knowledge on pathophysiology and ICU treatment – A narrative review. Best Pract Res Clin Anaesthesiol 2021;35:351‑68.

Yuan Z, Wang J, Feng F, Jin M, Xie W, He H, et al. The levels and related factors of mental workload among nurses: A systematic review and meta‑analysis. Int J Nurs Pract 2023;29:e13148.

Mohammadi F, Hanifi N, Bahraminegad N. Investigating the relationship between nurses’ mental workload and the quality of care services in intensive care unit. J Crit Care Nurs 2021;14:38‑47.

Altafin JAM, Grion CMC, Tanita MT, Festti J, Cardoso LTQ, Veiga CFF, et al. Nursing Activities Score and workload in the intensive care unit of a university hospital. Rev Bras Ter Intensiva 2014;26:292‑8.

Wu T, Zuo Z, Kang S, Jiang L, Luo X, Xia Z, et al. Multi‑organ Dysfunction in Patients with COVID‑19: A systematic review and meta‑analysis. Aging Dis 2020;11:874‑94.

Padilha KG, de Sousa RMC, Queijo AF, Mendes AM, Miranda DR. Nursing Activities Score in the intensive care unit: Analysis of the related factors. Intensive Crit Care Nurs 2008;24:197‑204.

Carrara FSA, Zanei SSV, Cremasco MF, Whitaker IY. Outcomes and nursing workload related to obese patients in the intensive care unit. Intensive Crit Care Nurs 2016;35:45‑51.


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