Impact of COVID-19 on nursing time in intensive care units in Belgium

Abstract

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.

The impact of COVID-19 on nursing workload and planning of nursing staff on the Intensive Care: A prospective descriptive multicenter study

“…The workload of the respiratory care was higher, which is in line with the higher number of ventilated COVID-19 ICU patients. The increase of workload in the category ‘Performing mobilization procedures with three or more nurses with any frequency’ can be explained by the frequency of turning patients into prone- or supine position as this became standard in the treatment of COVID-19 ICU patients ( Bruyneel et al, 2021 , Azoulay, 2020 , Coppo et al, 2020 ). We also found a difference in workload in the support and care of the patient and his or her relatives.…”

“…The nursing workload of patients with COVID-19 pneumonia was perceived high compared to the average patient admitted to the ICU. Recent research showed that in Italy and Belgium the nursing workload as expressed with the Nursing Activities Score was higher in patients with COVID-19 compared to other ICU patients ( Lucchini et al, 2020 , Bruyneel et al, 2021 ). Moreover, due to the pressure on ICU beds there was no capacity left for planned surgical patients with a need for postoperative care on the ICU ( Dutch COVID-19, 2020 ).…”

Experiences of critical care nurses fighting against COVID‐19: A qualitative phenomenological study

“…Recent studies have highlighted the diagnosis, clinical characteristics and treatment, 3 and the disease prevalence 27 . Other studies have discussed the seriousness of psychological issues on medical personnel 28,29 and the importance of providing psychological help for them 30 . Few studies have been conducted regarding the experiences of critical care nurses caring for individuals infected by COVID‐19 in Iran.…”

Attitudes towards COVID-19 Vaccination among Hospital Staff—Understanding What Matters to Hesitant People

“…As of December 2020, more than 18 million individuals had been infected with COVID-19 in Europe and around 412,000 had died [ 1 ], of which 17,000 were in Belgium [ 2 ]. The pandemic had had a serious impact on hospital burden and on the working conditions and mental health of healthcare professionals (HCPs) [ 3 , 4 , 5 ]. Yet vaccination was under way, with the first COVID-19 vaccines being evaluated and approved by the European Medicines Agency and the European Commission, and national and international vaccination strategies being developed.…”