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Impact of COVID-19 on nursing time in intensive care units in Belgium
The COVID-19 pandemic has had a significant impact on nursing practice in intensive care unit and consequently, on workload.
To assess the nurse-patient ratio required by COVID-19 patients and to identify the factors that influence nursing in this context.
This study was a retrospective observational study that evaluated the ratio using the Nursing Activities Score (NAS).
Three Belgian French-speaking hospitals, including five ICUs. Patients included COVID-19 and non-COVID-19 patients.
The study included 95 COVID-19 patients and 1604 non-COVID-19 patients (control group) resulting in 905 and 5453 NAS measures, respectively. The NAS was significantly higher among the COVID-19 patients than in the control group (p = <0.0001). In the COVID-19 group, these higher scores were also observed per shift and uniformly across the three hospitals. COVID-19 patients required more time in the activities of monitoring and titration (χ2 = 457.60, p = <0.0001), mobilisation (χ2 = 161.21, p = <0.0001), and hygiene (χ2 = 557.77, p = <0.0001). Factors influencing nursing time measured by NAS in the COVID-19 patients were age <65 years old (p = 0.23), the use of continuous venovenous hemofiltration (p = 0.002), a high APACHE II score (p = 0.006) and patient death (p = 0.002). A COVID-19 diagnosis was independently associated with an increase in nursing time (OR = 4.8, 95% CI:3.6–6.4).
Patients hospitalised in the ICU due to COVID-19 require significantly more nursing time and need an average ratio of almost 1:1.
Journal Article
Prevalence and reasons for missed nursing care in adult intensive care units
To explore missed nursing care activities and possible reasons in adult intensive care units in mainland China. A descriptive study. ICU nurses were recruited by convenience sampling between August 2023 and October 2023. They were asked to complete the missed intensive nursing care scale (MINCS) consisted in three parts (Basic information of participants, missed care elements in ICU and reasons for missing). Data analysis was conducted through descriptive, univariate and multivariate analyses. We followed the RANCARE guideline and STROBE checklist when reporting this study. A total of 550 registered nurses participated in this study. The total scores for missed nursing care items in ICU ranged from 38 to 167 points, with an average item score of (1.79 ± 0.72). Nursing activities related to satisfy patients’ physiological and emotional needs were most frequently missed. The scores for the causes of such omissions ranged from 23 to 92 points, with an average item score of (2.44 ± 0.81). Nurse professional burnout, inadequate human resource allocation, and insufficient competence were the most commonly reported reasons by ICU nurses. Moreover, nurses’ gender and job title were found to be associated with MNC in the ICU (
p
< 0.001).
Journal Article