Abstract
Introduction: The COVID-19 pandemic has had a significant effect on the healthcare sector, particularly in the intensive care and respiratory areas. Nurses working in these areas have experienced work overload that has had a negative impact on quality of care and patient safety. Objective: To assess nursing workload during the care of COVID-19 patients in two respiratory units using the Nursing Activities Score (NAS). Methodology: A descriptive, cross-sectional study was carried out. Sociodemographic variables and NAS scores were analyzed. Results: A study was conducted, including 452 patients hospitalized in respiratory care units due to COVID-19. The mean age in the group with low NAS scores was 57.6 ± 19.8 years, while in the group with high NAS scores it was 60.3 ± 21.7 years. Statistical analysis revealed that a high NAS score was associated with the presence of comorbidities, a prolonged hospital stay, and a higher mortality rate, with a p value of less than 0.00. Discussion: These results suggest that patients with COVID-19 exhibit similar clinical and demographic characteristics worldwide and that the existence of pre-existing conditions and length of hospitalization could be crucial elements influencing the severity of the condition and mortality rate. Conclusions: The COVID-19 patient population in this study presented clinical and demographic particularities similar to previous research on the disease. The presence of pre-existing diseases, hospitalization time, and mortality were related to high NAS in this population.
References
Bambi S, Iozzo P, Lucchini A. New issues in nursing management during the COVID-19 Pandemic in Italy. Am J Crit Care. 2020; 29(4): e92-e93. doi: https://doi.org/10.4037/ajcc2020937
Lucchini A, Iozzo P, Bambi S. Nursing workload in the COVID-19 era. Intensive Crit Care Nurs. 2020; 61(59): 102929. doi: https://doi.org/10.1016/j.iccn.2020.102929
Bruyneel A, Gallani MC, Tack J, Hondt A, Canipel S, Franck S, et al. Impact of COVID-19 on nursing time in intensive care units in Belgium. Intensive Crit Care Nurs. 2021; 62: 102967. doi: https://doi.org/10.1016/j.iccn.2020.102967
Bruyneel A, Tack J, Droguet M, Maes J, Wittebole X, Miranda R, et al. Measuring the nursing workload in intensive care with the Nursing Activities Score (NAS): A prospective study in 16 hospitals in Belgium. J Crit Care. 2019; 54: 205-211. doi: https://doi.org/10.1016/j.jcrc.2019.08.032
Kerlin MP, Costa DK, Davis BS, Admon AJ, Vranas KC, Kahn JM. Actions taken by US hospitals to prepare for increased demand for intensive care during the first wave of COVID-19: A National Survey. Chest. 2021; 160(2): 519-528. doi: https://doi.org/10.1016/j.chest.2021.03.005
Marks, S, Edwards S, Jerge E. Rapid deployment of critical care nurse education during the COVID-19 pandemic. Nurse Lead. 22021; 19(2): 165-169. doi: https://doi.org/10.1016/j.mnl.2020.07.008
Baudewyns V, Bruyneel A, Smith P, Servotte JC, Dancot J. Prevalence and factors associated with academic burnout risk among nursing and midwifery students during the COVID-19 pandemic: A crosssectional study. Nurs Open. 2023; 10(5): 3232-3242. doi: https://doi.org/10.1002/nop2.1575
Debergh DP, Myny D, Van Herzeele I, Van Maele G, Reis Miranda D, Colardyn F. Measuring the nursing workload per shift in the ICU. Intensive Care Med. 2012; 38(9): 1438-1444. doi: https://doi.org/10.1007/s00134-012-2648-3
Miranda DR, Nap R, de Rijk A, Schaufeli W, Iapichino G; TISS working group. therapeutic intervention scoring system. Nursing activities score. Crit Care Med. 2003; 31(2): 374-382. doi: https://doi.org/10.1097/01.CCM.0000045567.78801.CC
Cáceres Rivera DIC, Ruiz Sandoval JP, Cristancho Zambrano LY, Pulido Montes MA, López Romero LA. Métodos empleados para cuantificar la carga de trabajo en Enfermería en las unidades de cuidados intensivos: Una revisión de la literature. Rev Cuid. 2022; 13(3): 23011-230113. doi: https://doi.org/10.15649/cuidarte.2301
Greaves J, Goodall D, Berry A, Shrestha S, Richardson A, Pearson P. Nursing workloads and activity in critical care: A review of the evidence. Intensive Crit Care Nurs. 2018; 48: 10-20. doi: https://doi.org/10.1016/j.iccn.2018.06.002
Hoogendoorn ME, Margadant CC, Brinkman S, Haringman JJ, Spijkstra JJ, de Keizer NF. Workload scoring systems in the Intensive Care and their ability to quantify the need for nursing time: A systematic literature review. Int J Nurs Stud. 2020; 101: 103408. doi: https://doi.org/10.1016/j.ijnurstu.2019.103408
Toscano F, Tommasi F, Giusino D. Burnout in intensive care nurses during the COVID-19 Pandemic: A scoping review on its prevalence and risk and protective factors. Int J Environ Res Public Health. 2022; 19(19): 12914. doi: https://doi.org/10.3390/ijerph191912914
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. doi: https://doi.org/10.1016/j.iccn.2020.102891
Grillo Padilha K, Stafseth S, Solms D, Hoogendoom M, Carmona Monge FJ, Hashem Gomaa O, et al. Nursing activities score: an updated guideline for its application in the Intensive Care Unit. Rev Esc Enferm USP. 2015; 49 (Spec):131-137. doi: https://doi.org/10.1590/S0080-623420150000700019
Santos Nobre RA, Menezes do Nascimento Rocha H, Santos FJ, Dantas dos Santos A, Gois de Mendonça R, Freire de Menezes A. Aplicación del nursing activities score (NAS) en diferentes tipos de UCI’s: una revisión integrativa. Enfermería Glob. 2019; 18(56): 485-528. doi: http://dx.doi.org/10.6018/eglobal.18.4.362201
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. doi: https://doi.org/10.1016/j.ijnurstu.2021.104005
Rivera DI, Torres, CC, López, LA. Factors associated with nursing workload in three intensive care units. Rev Esc Enfermagem USP. 2021; 55: e20200272. doi: https://doi:10.1590/1980-220XREEUSP-2020-0272
Cáceres Rivera, DI, Torres CC, Cristancho Zambrano LY, López Romero LA. Carga laboral de los profesionales de enfermería en unidad de cuidados intensivos. Estudio descriptivo: «CARETIME».” Acta Col Cuidado Intensivo 2020; 20(2): 92-97. doi: https://doi.org/10.1016/j.acci.2019.12.002
Margadant C, de Keizer NF, Hoogendoorn ME, Bosman RJ, Spijkstra JJ, Brinkman S. Nurse Operation Workload (NOW), a new nursing workload model for intensive care units based on time measurements: An observational study. Int J Nurs Stud. 2021; 113: 103780. doi: https://doi.org/10.1016/j.ijnurstu.2020.103780
Stuedahl M, Vold S, Klepstad, Stafseth SK. Interrater reliability of nursing activities score among intensive care unit health professionals. Rev Esc Enferm USP. 49 (2015): 117-122. doi: http://dx.doi.org/10.1590/S0080-623420150000700017
Janzantte Ducci A, Grillo Padilha K. Nursing activities score: a comparative study about retrospective and prospective applications in intensive care units. Acta Pau Enferm. 2008; 21(4): 581-587. doi: 10.1590/S0103-21002008000400008
Carmona-Monge FJ, Rollán Rodríguez GM, Quirós Herranz C, García Gómez S, Marín-Morales D. Evaluation of the nursing workload through the nine equivalents for nursing manpower use scale and the nursing activities score: a prospective correlation study. Intensive Crit Care Nurs. 2013; 29(4): 228-233. doi: https://doi.org/10.1016/j.iccn.2013.03.003
Grillo Padilha K, Cardoso de Sousa RM, Ferreira Queijo A, Mendes AM, Reis Miranda D. Nursing activities score in the intensive care unit: analysis of the related factors. Intensive Crit Care Nurs. 2008; 24(3): 197-204. doi: https://doi.org/10.1016/j.iccn.2007.09.004
Zhang H, Du F, Cao XJ, Feng XI, Zhang HP, Wu ZX, et al. Clinical characteristics of coronavirus disease 2019 (COVID-19) in patients out of Wuhan from China: a case control study. BMC Infect Dis. 2021; 21(1): 207. doi: https://doi:10.1186/s12879-021-05897-z
Fu L, Wang B, Yuan T, Chen X, Ao Y, Fitzpatrick T, et al. Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: A systematic review and meta-analysis. J Infect. 2020; 80(6): 656-665. doi: https://doi:10.1016/j.jinf.2020.03.041
Hu B, Guo H, Zhou P, Shi ZL. Characteristics of SARS-CoV-2 and COVID-19. Nat Rev Microbiol. 2021; 19(3): 141-154. doi: https://doi.org/10.1038/s41579-020-00459-7
Lucchini A, Giani M, Elli S, Villa S, Rona R, Foti G. Nursing Activities Score is increased in COVID-19 patients. Intensive Crit Care Nurs. 2020; 59:102876. doi: https://doi.org/10.1016/j.iccn.2020.102876
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. doi: https://doi:10.1016/j.iccn.2020.102891
Andel SA, Tedone AM, Shen W, Arvan ML. Safety implications of different forms of understaffing among nurses during the COVID-19 pandemic. J Adv Nurs. 2022; 78(1): 121-130. doi: https://doi:10.1111/jan.14952
Lasater KB, Aiken LH, Sloane DM, French R, Martin B, Reneau K, et al. Chronic hospital nurse understaffing meets COVID-19: an observational study. BMJ Qual Safety. 2021; 30: 639-647. doi: http://dx.doi.org/10.1136/bmjqs-2020-011512
Uranga A, Villanueva A, Lafuente I, González N, Legrreta MJ, Aguirre U, et al. Factores de riesgo de deterioro clínico en pacientes ingresados por COVID-19: estudio caso-control Rev Clin Esp. 2022; 222(1): 22-30. doi: https://doi:10.1016/j.rce.2021.04.007
Chumbi Sigcho F, Román Collazo C, Moreno Bravo J, Velecela Chumbi J. Factores asociados a la infección y muerte por Covid-19, un análisis ecológico. Vive Rev Salud [Internet]. 2021; 4(12): 250-262. doi: https://doi.org/10.33996/revistavive.v4i12.124
Saldías Peñafiel F, Peñaloza Tapia A, Farías Nesvadba D, Farcas Oksenberg K, Reyes Sánchez A, Cortés Meza J, et al. Manifestaciones clínicas y predictores de gravedad en pacientes adultos con infección respiratoria aguda por coronavirus SARS-CoV-2. Rev Med Chil. 2020;148(10): 1387-1397. doi: https://doi.org/10.4067/s0034-98872020001001387
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2024 Gustavo Edgardo Jiménez-Hernández, Yesenia Margarita Peña-Jaramillo