Nursing workload and severity of COVID-19 patients in the Intensive Care Unit.
Wesley Cajaiba Santos, Maria Carolina Barbosa Teixeira Lopes, Cassia Regina Vancini-Campanharo and 5 others
PMID 39190876WHAT IT FOUND
In 217 adult ICU patients with COVID-19, nursing workload was not associated with patient severity, ventilation time, ICU stay, discharge or death.
The average daily workload was 84.79 on the Nursing Activities Score, equivalent to 20.34 hours of nursing care.
Key findings
01Nursing workload was not associated with patient severity, age, mechanical ventilation time, ICU stay, discharge or death.
02Across 3547 daily Nursing Activities Score records, the average workload was 84.79, which the paper states is equivalent to 20.34 hours of nursing care.
03Higher patient severity was associated with older age, longer mechanical ventilation, longer ICU stay, sedentary lifestyle and death.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Single centre in a private hospital, so results may not apply to other ICUs. Severity was measured only on admission, while nursing workload was measured daily, making the workload-severity link hard to interpret. The study was observational and did not test staffing changes, so it cannot show that workload or ratios caused outcomes. Patients with incomplete variables were excluded. Informed consent was waived because many patients were seriously ill and the study occurred during a public health emergency.
The easy way to misread this
Do not conclude that higher nurse staffing improved or worsened patient outcomes. The study found no significant association between nursing workload ratios and discharge, death, ventilation time or ICU stay, and it was a single-centre observational study with severity measured only on admission.