Evaluation of Nursing Workload in Intesive Care Unit
1Department of Internal Medicine, Division of Intensive Care, Hacettepe University School of Medicine, Ankara, Turkey
J Crit Intensive Care 2017; 8(1): 1-5 DOI: 10.5152/dcbybd.2017.1353
Full Text PDF

Abstract

Objective: Nursing workload affects patient outcomes in intensive care units (ICUs). The effective use of resources requires planning of nursing workload. We aimed to determine nursing workload, the required number of nurses in ICUs, and differences in nursing workload among ICUs using Therapeutic Intervention Scoring System-28 (TISS-28).
Material and Methods: The study was retrospectively performed in medical ICUs of the Medical Faculty, Division of Medical Intensive Care between September 1 and September 19, 2016.
Results: TISS-28 scores were calculated in 39 patients for 19 days. There were 17 patients (43.6%) in ICU-1 (9 beds), 13 patients (33.3%) in ICU-2 (8 beds), and 9 patients (23.1%) in ICU-3 (6 beds). The mean age of the patients was 66.8±17.3 years, and the mean APACHE II score was 23±7.5. The mean TISS-28 score was 27.6±5.6. APACHE II scores, TISS-28 scores, and length of ICU stay were not different among the ICUs. The number of nurses required to work in each 8-h shift was 5.1±1.2 in ICU-1, 3.6±0.5 in ICU-2, and 3.3±1 in ICU-3 (p<0.001). During the study period, the number of nurses actively working per shift was lower than the required number of nurses and the mean number of working nurses were 3, 3.3, and 2.3, respectively. TISS-28 scores and nursing workload for patients who died were higher than those for patients who survived (p=0.007 and p=0.043, respectively).
Conclusion: Nursing workload can be different in different ICUs, and current nursing planning is not consistent with the required numbers according to nursing workload. The number of nurses should be planned according to nursing workload rather than bed numbers or empirical values.