Beyond order-based nursing workload: A retrospective cohort study in intensive care units

Area of Science:

• Nursing workload analysis
• Healthcare management
• Clinical operations

Background:

• Rising nurse burnout and shortages necessitate a deeper understanding of nursing workload.
• Current workload metrics may not fully capture nurses' actual experiences.
• Identifying contributing factors is crucial for effective resource allocation and retention.

Purpose of the Study:

• To compare order-based nursing workload with clinically perceived workload.
• To identify and quantify factors influencing clinically perceived nursing workload.
• To inform interventions aimed at mitigating nurse burnout and shortage.

Main Methods:

• Retrospective cohort study utilizing observational data.
• Integration of patient flow, nurse staffing, and workload intensity data.
• Multivariate linear regression analysis to determine factors affecting perceived workload.

Main Results:

• Clinically perceived workload exceeded order-based workload in 53% of cases.
• Factors increasing perceived workload include weekend/night shifts, higher patient census, early post-admission patients (within 24h), and male patients.
• Quantified the impact of various shift, patient, and nurse-level factors.

Conclusions:

• Order-based workload measures tend to underestimate the actual demands on nurses.
• Identified specific, quantifiable factors that elevate clinically perceived workload.
• Proposed targeted interventions for nurse managers to alleviate workload, reduce burnout, and address shortages.