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

Abstract

Introduction The impact of the care for COVID-19 patients on nursing workload and planning nursing staff on the Intensive Care Unit has been huge. Nurses were confronted with a high workload and an increase in the number of patients per nurse they had to take care of. Objective The primary aim of this study is to describe differences in the planning of nursing staff on the Intensive Care in the COVID period versus a recent non-COVID period. The secondary aim was to describe differences in nursing workload in COVID-19 patients, pneumonia patients and other patients on the Intensive Care. We finally wanted to assess the cause of possible differences in Nursing Activities Scores between the different groups. Methods We analyzed data on nursing staff and nursing workload as measured by the Nursing Activities Score of 3,994 patients and 36,827 different shifts in 6 different hospitals in the Netherlands. We compared data from the COVID-19 period, March 1st 2020 till July 1st 2020, with data in a non-COVID period, March 1st 2019 till July 1st 2019. We analyzed the Nursing Activities Score per patient, the number of patients per nurse and the Nursing Activities Score per nurse in the different cohorts and time periods. Differences were tested by a Chi-square, non-parametric Wilcoxon or Student's t-test dependent on the distribution of the data. Results Our results showed both a significant higher number of patients per nurse (1.1 versus 1.0, p<0.001) and a significant higher Nursing Activities Score per Intensive Care nurse (76.5 versus 50.0, p<0.001) in the COVID-19 period compared to the non-COVID period. The Nursing Activities Score was significantly higher in COVID-19 patients compared to both the pneumonia patients (55.2 versus 50.0, p<0.001) and the non-COVID patients (55.2 versus 42.6, p<0.001), mainly due to more intense hygienic procedures, mobilization and positioning, support and care for relatives and respiratory care. Conclusion With this study we showed the impact of COVID-19 patients on the planning of nursing care on the Intensive Care. The COVID-19 patients caused a high nursing workload, both in number of patients per nurse and in Nursing Activities Score per nurse.

Promoting and Risk Factors of Nurses’ Hardiness Levels during the COVID-19 Pandemic: Results from an Italian Cohort

“…Italy was the first European country that was required to manage the COVID-19 emergency, and implemented a large number of social, economic, and healthcare changes [33]. Nurses' managers, as a consequence of hospitals' re-organizations, had to deal with a contingent of nurses who were newly hired or moved into more complex clinical settings, and gap in critical care competencies had to be quickly filled [34,35]. Similar circumstances also occurred during the reconversion of general wards into COVID-19 acute care wards.…”

Covid-19, diseño biomecánico del puesto de auxiliar de enfermería. Caso del hospital: Universidad Técnica particular de Loja.

“…La pandemia por coronavirus es una enfermedad infecciosa causada por el COVID-19 que ha generado demasiados problemas no solo a las personas contagiadas sino también al personal de salud que se involucra en su tratamiento (Ahmed, Ramadan, Refay, Khashbah, & neurosurgery, 2021). Muchas de las personas que sufren esta enfermedad determinan el uso de instrumentos para soporte vital en lugares especiales denominados Unidades de Cuidados Intensivos, con la asistencia de personal especializado que ejecuta actividades de levantamiento, traslado y manipulación de pacientes que exigen los niveles normales de aplicación, asimiento de fuerzas generadas por la repetitividad, duración de las posturas y pesos que sujeta el personal de salud (Hoogendoorn et al, 2021) y causan afectación en su bienestar físico.…”

Impact of COVID-19 on nursing workload as measured with the Nursing Activities Score in intensive care

“…The Dutch study also showed an increase in the patient per nurse ratio during the pandemic compared to a non-COVID-period (1.1 vs. 1.0, p < 0.001) with an increase of 30% at the peak of the COVID-19 period (Median (IQR) 1.3 (0.9 -1.8) vs. 1.0 (0.6 -1.2), p<0.001). They also described an increase of the NAS per nurse (76.5 versus 50.0, p < 0.001) during the pandemic, with an increase of 98% at the peak in April 2020 (Median (IQR) 89.6 (63.8 -117.2) vs. 45.2 (27.5 -68.7), p<0.001) (Hoogendoorn et al, 2021).…”

“…The unexpected outbreak and the drastic measures required to cope with the COVID-19 pandemic have rapidly changed intensive care unit (ICU) activity. COVID-19 patients more often require mechanical ventilation, have a higher severity of illness and mortality and an increased length of ICU stay (Hoogendoorn et al, 2021). All over the world, ICUs were confronted with a sudden demand for extra ICU beds for COVID-19 patients (Kerlin et al, 2021).…”

“…To date, three studies have been published analyzing the impact of COVID-19 on nursing workload (table 1). The studies were carried out in Italy, Belgium, and the Netherlands and all used the NAS (Lucchini et al, 2020a;Bruyneel et al, 2021a;Hoogendoorn et al, 2021).…”