Direct versus Indirect Nursing Care in Intensive Care Units during COVID-19 (An Observational Study)

Area of Science:

• Nursing
• Intensive Care Unit (ICU) Care
• Pandemic Response

Background:

• Nurses provide essential care in Intensive Care Units (ICUs).
• The COVID-19 pandemic significantly impacted healthcare delivery and nursing workloads.
• This study focused on comparing direct and indirect nursing care during the pandemic.

Purpose of the Study:

• To compare the time spent on direct and indirect nursing care in an ICU setting.
• To identify the types of direct and indirect nursing activities performed during the COVID-19 pandemic.
• To analyze the differences in time allocation between direct and indirect care.

Main Methods:

• An observational study was conducted in an ICU in Tehran in 2022.
• 42 nurses' activities were continuously observed and recorded.
• Data on direct and indirect care were collected using a modified International Classification for Nursing Practice checklist and analyzed with a dependent t-test.

Main Results:

• Indirect care, such as report writing (34.90 min), consumed more time than direct care activities like cardiopulmonary resuscitation (27.30 min).
• The least time for direct care was for deltoid injections (4.8 min), and for indirect care was removing personal protective equipment (6.11 min).
• A significant difference was found, with nurses spending more time on indirect care (t = -6.62, p < 0.001).

Conclusions:

• Indirect nursing care was provided more frequently than direct care.
• Increased demand for indirect care is linked to staffing shortages and increased patient numbers during the pandemic.
• Findings suggest a need to reassess nursing care delivery models in ICUs to optimize efficiency.