The Critical Vs Non-critical Nursing Care Workload In The Intensive Care Unit | 107550
Journal of Nursing & Care
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Statement of the Problem: Appropriate nursing manpower allocation is essential for quality of care of Intensive
Care Unit (ICU). Due to the acuity of the patients, the nursing care activities are complicated and are not limited
to life saving interventions. The purpose of this study was to examine the content of nursing care workload in the
Methods: We adopted Nursing Activities Score (NAS) to examine the nursing workload in a medical center in
Northern Taiwan. The 23-item NAS which was developed by Miranda et al. in 2003 based on data of 2105 patients
in 99 ICUs from15 European countries was used. NAS was widely used by European countries in nursing allocation
for years and with research reports published.
Findings: From October to December of 2017, a total of 1691 shifts of the nursing activities were recorded, including
completed 3 shifts from 528 patients. From the 1691 NAS scores, the top five most frequent nursing activities were:
Ventilator support, bedside monitoring and measurement, administrative and managerial tasks, patient moving
and positioning, renal support interventions. The top five most time consuming nursing activities were: Patient
moving and positioning (532.8 min/24 hours), bedside monitoring and measurement (488.4 minutes/24 hours),
bathing and cleaning (341.4 min/24 hours), renal support interventions (292.2 min/24 hours), administrative and
managerial tasks (288.9 min/24 hours). The order may vary among different ICUS but the top 5s was the same.
Among the top five most frequent time consuming nursing activities, some are general, not critical nursing care.
These findings further support the report of Miranda et al. (2003) that only 30% of the nursing activities in ICU
were critical care.
Conclusion: The re-design of the job description of nurses in ICU is necessary. The introducing of the supplemental
manpower to share the non-critical nursing activities can be considered as an alternative solution for overload
problems in ICUs.
Yann-Fen Chao has completed her PhD study from Rush University College of Nursing in 1991. Currently she is a Chair Professor and Dean of College of Nursing at Hungkuang University in Taichung City, Taiwan. She has published more than 100 research papers with 44 in SCI journals. She also has been served as an Editorial Board Member of a SCI journal. Her research areas were patient safety, symptom management and nursing education.