Perceptions of Cognitive Load and Workload in Nurse Handoffs: A Comparative Study Across Differing Patient-Nurse...

Area of Science:

• Nursing Research
• Patient Safety
• Healthcare Management

Background:

• Medical errors during patient handoffs contribute to preventable deaths and patient harm.
• Effective communication during handoffs is crucial for patient safety.
• Nurses' workload and cognitive load during handoffs are influenced by unit factors.

Purpose of the Study:

• To examine nurses' perceived workload and cognitive load during patient handoffs.
• To investigate the impact of patient acuity and patient-nurse ratios on handoff workload.
• To identify factors influencing cognitive load during nursing handoffs.

Main Methods:

• The study analyzed 20 handoff dyads at a southeastern US medical facility.
• The National Aeronautics and Space Administration Task Load Index (NASA-TLX) was used to measure perceived workload and cognitive load.
• Linear regressions, Fisher exact test, and Wilcoxon rank sum test were employed for data analysis.

Main Results:

• Higher patient acuity and patient-nurse ratios were significantly associated with increased mental demand and perceived performance decrements during handoffs (P = .007, P = .008).
• No significant associations were found between these factors and nurses' roles (P > .05).
• Medical-surgical units reported higher cognitive load compared to other units.

Conclusions:

• Patient acuity and nurse staffing levels significantly impact nurses' cognitive load and perceived performance during handoffs.
• Targeted interventions, including standardized handoff protocols and technological aids, are necessary to mitigate workload and cognitive load.
• Addressing variability in cognitive load across units, particularly medical-surgical units, is essential for improving patient safety and reducing medical errors.