Staff workload and adverse events during mechanical ventilation in neonatal intensive care units

Filho, Fernando Lamy; Silva, Antônio Augusto Moura da; Lopes, José M. A.; Lamy, Zeni Carvalho; Santos, Alcione Miranda dos

doi:10.2223/jped.2140

Cited by 11 publications

(5 citation statements)

References 19 publications

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“…Nurse workload, defined as the “the amount of performance required to carry out nursing activities” (p464) and frequently measured using resource-based objective metrics, such as infant-to-nurse staffing ratios or patient acuity scores, has been correlated with infant outcomes in NICUs, including risk of hospital-acquired infection, adverse events, and in-hospital mortality . However, explanation of the mechanisms underlying these associations is lacking.…”

Section: Introductionmentioning

confidence: 99%

Association of Nurse Workload With Missed Nursing Care in the Neonatal Intensive Care Unit

et al. 2019

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IMPORTANCE Quality improvement initiatives demonstrate the contribution of reliable nursing care to gains in clinical and safety outcomes in neonatal intensive care units (NICUs); when core care is missed, outcomes can worsen.OBJECTIVE To evaluate the association of NICU nurse workload with missed nursing care. DESIGN, SETTING, AND PARTICIPANTSA prospective design was used to evaluate associations between shift-level workload of individual nurses and missed care for assigned infants from March 1, 2013, through January 31, 2014, at a 52-bed level IV NICU in a Midwestern academic medical center. A convenience sample of registered nurses who provided direct patient care and completed unit orientation were enrolled. Nurses reported care during each shift for individual infants whose clinical data were extracted from the electronic health record.

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Section: Introductionmentioning

confidence: 99%

Association of Nurse Workload With Missed Nursing Care in the Neonatal Intensive Care Unit

et al. 2019

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“…Os artigos seis e nove, associando carga de trabalho da equipe e EAs, demonstram que esta associação é verdadeira principalmente nos EAs relacionados à ventilação mecânica neonatal, como afirma o artigo seis (16) . Já o nove faz uma avaliação com os profissionais da equipe médica e de enfermagem das UTINs, sendo evidenciado que conforme os profissionais vão adquirindo mais tempo de trabalho, passam a optar por respostas menos positivas relacionadas à cultura de segurança do paciente (18) .…”

Section: Referênciasunclassified

Repensando a Segurança Do Paciente Em Unidade De Terapia Intensiva Neonatal: Revisão Sistemática

Sousa¹,

Santana²,

Santos³

et al. 2016

Cogitare Enferm.

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RECONSIDERING PATIENT SAFETY AT NEONATAL INTENSIVE CARE UNITS: A SYSTEMATIC REVIEW ABSTRACT:The objective was to get to know adverse events and care practices for the purpose of patient safety at a Neonatal Intensive Care Unit. Systematic review using the following descriptors: Patient Safety; Intensive Care Units, Neonatal; Adverse events. Study developed between September 2015and February 2016. Eighty-four articles were found in three databases between 2006 and 2015. After applying the screening and eligibility criteria, nine articles were selected. The analysis of the articles revealed that adverse events take place at the Neonatal Intensive Care Units, which are attributed to different factors. The actions mentioned to prevent the adverse events were continuing education, training and an increasing number of professionals, support from management, knowledge strengthening and team commitment. In conclusion, the most noteworthy adverse events were related to medication, respiratory infections and non-programmed extubations. The main factors contributing to error were excessive workloads, lack of professionals and resources and an unfavorable work environment.

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“…Clinician workload is a critical factor in the evaluation of clinical and operational procedures including clinician performance (Mazur et al, 2016), medical student supervision (Celebi et al, 2012) and staffing decisions (Upenieks et al, 2007) in healthcare systems. Workload has a profound effect on the provision of healthcare delivery services due to its association with provider burnout (Portoghese et al, 2014;Leiter and Maslach, 2005;Holden et al, 2011), staffing challenges such as nurse turnover and shortages (Duffield and O'Brien-Pallas, 2003), and undesired patient outcomes such as medication error likelihood (Holden et al, 2011), mortality (Neuraz et al, 2015;Ball et al, 2018;Tarnow-Mordi et al, 2000), adverse events related to mechanical ventilation (Filho et al, 2011), length of stay (LOS) and procedure related infections (Müller de Magalhães et al, 2017). Aiken et al (2002) found that adding one patient to a nurse's workload was associated with additional 23 percent odds of reporting burnout.…”

Section: Introductionmentioning

confidence: 99%

Objective measures of workload in healthcare: a narrative review

Fishbein

Nambiar

McKenzie

et al. 2019

IJHCQA

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Purpose Workload is a critical concept in the evaluation of performance and quality in healthcare systems, but its definition relies on the perspective (e.g. individual clinician-level vs unit-level workload) and type of available metrics (e.g. objective vs subjective measures). The purpose of this paper is to provide an overview of objective measures of workload associated with direct care delivery in tertiary healthcare settings, with a focus on measures that can be obtained from electronic records to inform operationalization of workload measurement. Design/methodology/approach Relevant papers published between January 2008 and July 2018 were identified through a search in Pubmed and Compendex databases using the Sample, Phenomenon of Interest, Design, Evaluation, Research Type framework. Identified measures were classified into four levels of workload: task, patient, clinician and unit. Findings Of 30 papers reviewed, 9 used task-level metrics, 14 used patient-level metrics, 7 used clinician-level metrics and 20 used unit-level metrics. Key objective measures of workload include: patient turnover (n=9), volume of patients (n=6), acuity (n=6), nurse-to-patient ratios (n=5) and direct care time (n=5). Several methods for operationalization of these metrics into measurement tools were identified. Originality/value This review highlights the key objective workload measures available in electronic records that can be utilized to develop an operational approach for quantifying workload. Insights gained from this review can inform the design of processes to track workload and mitigate the effects of increased workload on patient outcomes and clinician performance.

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Staff workload and adverse events during mechanical ventilation in neonatal intensive care units

Cited by 11 publications

References 19 publications

Association of Nurse Workload With Missed Nursing Care in the Neonatal Intensive Care Unit

Association of Nurse Workload With Missed Nursing Care in the Neonatal Intensive Care Unit

Repensando a Segurança Do Paciente Em Unidade De Terapia Intensiva Neonatal: Revisão Sistemática

Objective measures of workload in healthcare: a narrative review

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