Workload and Patient Safety Among Critical Care Nurses

doi:10.1016/j.ccell.2007.02.001

Critical Care Nursing Clinics of North America

Volume 19, Issue 2, June 2007, Pages 121-129

https://doi.org/10.1016/j.ccell.2007.02.001 Get rights and content

Several dimensions of workload experienced by nurses working in ICUs are described in this article, including the physical workload related to patient handling. The effects of workload on various outcomes, such as the health, safety, and quality of working life of nurses, and the safety of care provided by ICU nurses are discussed. A systemic approach to the assessment of workload is proposed that is aimed at identifying the work system factors that contribute to the different facets of workload and the interdependencies among the various dimensions of workload.

Section snippets

Dimensions of workload

Table 1 shows the various dimensions of workload of critical care nurses and provides examples of each of the dimensions.

Sources of workload

Understanding that the way work is organized can contribute to workload is critical for developing interventions aimed at reducing (or managing) workload and its impact on critical care nurses. A range of patient care factors also may contribute to high workload in ICUs, such as the number of postoperative events [35].

The authors propose that the work system model of Carayon and Smith [36], [37], [38] can be used to describe sources of workload and define the interrelationships between the

Impact of workload

Workload experienced by critical care nurses can lead to various outcomes: (1) impact on health of the nurses, (2) quality of working life (eg, job dissatisfaction, stress, burnout, and turnover intention), and (3) patient safety (see Fig. 1).

Summary

Interventions aimed at improving the safety of care provided by nurses to critical care patients need to consider the work environment, in particular the various types of workload. Sluiter and colleagues [56] implemented a multidisciplinary structured process to evaluate work shifts to enhance team communication. Benefits of the intervention included increased satisfaction with team communication and reduction in emotional exhaustion. This multidisciplinary structured process was used to

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Workload and Patient Safety Among Critical Care Nurses

Section snippets

Dimensions of workload

Sources of workload

Impact of workload

Summary

Intensive Crit Care Nurs

Intensive Care Nurs

Intensive Care Nurs

Ann Emerg Med

J Emerg Nurs

Nutrition

Appl Ergon

Int J Ind Ergon

J Am Coll Cardiol

Int J Nurs Stud

Int J Nurs Stud

Stress and work relationships in the neonatal intensive care unit: are they worse than in the wards

J Paediatr Child Health

Computer-aided self-observation psychological stressors in an ICU

Int J Clin Monit Comput

Stress and mental health in neonatal intensive care units

Arch Dis Child

Problems associated with nursing staff shortage: an analysis of the first 3600 incident reports submitted to the Australian Incident Monitoring Study (AIMS-ICU)

Anaesth Intensive Care

Simplified therapeutic intervention scoring system: the TISS-28 items—results from a multicenter study

Crit Care Med

Quantitating caregiver work load in the ICU: the therapeutic intervention scoring system

Respir Care

Nine equivalents of nursing manpower use score (NEMS)

Intensive Care Med

Nursing activities score

Crit Care Med

Development of a comprehensive scoring system to measure multifaceted nursing workloads in ICU

Nurs Health Sci

Measuring nursing workload in neonatal intensive care

J Nurs Manag

Understanding the complexity of registered nurse work in acute care settings

J Nurs Adm

Work related risk factors for musculoskeletal complaints in the nursing profesion: results of a questionnaire survey

Occup Environ Med

A growing physical workload threatens nurses' health

Am J Nurs

Critical care delivery in the intensive care unit: defining clinical roles and the best practice model

Crit Care Med

Physically demanding work and inadequate sleep, pain medication use, and absenteeism in registered nurses

J Occup Environ Med

Critical care nurses, ethical decision-making and stress

J Adv Nurs

Understanding the cognitive work of nursing in the acute care environment

J Nurs Adm