Objective: Burnout is a global work-related phenomenon. Intensive care unit (ICU) nurses are at risk of burnout and the COVID-19 pandemic may increase this risk. The objectives of this study were to assess the prevalence of burnout risk and identify risk factors among ICU nurses during the COVID-19 pandemic. Research methodology: Web-based survey performed during the first wave of the COVID-19 pandemic in French speaking Belgium. Main outcome measures: Risk of burnout was assessed with the Maslach Burnout Inventory scale. Results: A total of 1135 ICU nurses responded to the questionnaire. The overall prevalence of burnout risk was 68%. A total of 29% of ICU nurses were at risk of depersonalisation (DP), 31% of reduced personal accomplishment (PA), and 38% of emotional exhaustion (EE). A 1:3 nurse-to-patient ratio increased the risk of EE (OR = 1.77, 95% CI: 1.07-2.95) and DP (OR = 1.38, 95% CI: 1.09-2.40). Those who reported having a higher perceived workload during the COVID-19 pandemic were at higher risk for all dimensions of burnout. Shortage of personal protective equipment increased the risk of EE (OR = 1.78, 95% CI: 1.35-3.34) and nurses who reported having symptoms of COVID-19 without being tested were at higher risk of EE (OR = 1.40, 95% CI: 1.68-1.87). Conclusions: Two-thirds of ICU nurses were at risk of burnout and this risk was associated with their working conditions during the first wave of the COVID-19 pandemic. We recommend monitoring the risk of burnout and implementing interventions to prevent and manage it, taking into account the factors identified in this study.

Introduction The COVID-19 pandemic has had a significant impact on nursing practice in intensive care unit (ICU) and, consequently, on workload. Objective To assess the nurse-patient (N:P) ratio required by COVID-19 patients and to identify the factors that influence nursing in this context. Design This study was a retrospective observational study that evaluated the N:P ratio using the Nursing Activities Score (NAS). Setting Three Belgian French-speaking hospitals, including five ICUs. Patients included COVID-19 and non-COVID-19 patients in the ICU. Measurements and Main Results The study included 95 COVID-19 patients and 1,604 non-COVID-19 patients (control group) resulting in 905 and 5,453 NAS measures, respectively. The NAS was significantly higher among the COVID-19 patients than in the control group (p=<0.0001). In the COVID-19 group, these higher scores were also observed per shift and uniformly across the three hospitals. COVID-19 patients required more time in the activities of monitoring and titration (χ2= 457.60, p=<0.0001), mobilisation (χ2= 161.21, p=<0.0001), and hygiene (χ2= 557.77, p=<0.0001). Factors influencing nursing time measured by NAS in the COVID-19 patients were age < 65 years old (p=0.23), the use of continuous venovenous hemofiltration (p=0.002), a high APACHE II score (p=0.006), and patient death (p=0.002). A COVID-19 diagnosis was independently associated with an increase in nursing time (OR=4.8, 95% CI:3.6-6.4). Conclusions Patients hospitalised in the ICU due to COVID-19 require significantly more nursing time and need an average N:P ratio of almost 1:1.