» Articles » PMID: 34273806

The Impact of COVID-19 on Nursing Workload and Planning of Nursing Staff on the Intensive Care: A Prospective Descriptive Multicenter Study

Overview
Journal Int J Nurs Stud
Specialty Nursing
Date 2021 Jul 17
PMID 34273806
Citations 46
Authors
Affiliations
Soon will be listed here.
Abstract

Introduction: The impact of the care for COVID-19 patients on nursing workload and planning nursing staff on the Intensive Care Unit has been huge. Nurses were confronted with a high workload and an increase in the number of patients per nurse they had to take care of.

Objective: The primary aim of this study is to describe differences in the planning of nursing staff on the Intensive Care in the COVID period versus a recent non-COVID period. The secondary aim was to describe differences in nursing workload in COVID-19 patients, pneumonia patients and other patients on the Intensive Care. We finally wanted to assess the cause of possible differences in Nursing Activities Scores between the different groups.

Methods: We analyzed data on nursing staff and nursing workload as measured by the Nursing Activities Score of 3,994 patients and 36,827 different shifts in 6 different hospitals in the Netherlands. We compared data from the COVID-19 period, March 1st 2020 till July 1st 2020, with data in a non-COVID period, March 1st 2019 till July 1st 2019. We analyzed the Nursing Activities Score per patient, the number of patients per nurse and the Nursing Activities Score per nurse in the different cohorts and time periods. Differences were tested by a Chi-square, non-parametric Wilcoxon or Student's t-test dependent on the distribution of the data.

Results: Our results showed both a significant higher number of patients per nurse (1.1 versus 1.0, p<0.001) and a significant higher Nursing Activities Score per Intensive Care nurse (76.5 versus 50.0, p<0.001) in the COVID-19 period compared to the non-COVID period. The Nursing Activities Score was significantly higher in COVID-19 patients compared to both the pneumonia patients (55.2 versus 50.0, p<0.001) and the non-COVID patients (55.2 versus 42.6, p<0.001), mainly due to more intense hygienic procedures, mobilization and positioning, support and care for relatives and respiratory care.

Conclusion: With this study we showed the impact of COVID-19 patients on the planning of nursing care on the Intensive Care. The COVID-19 patients caused a high nursing workload, both in number of patients per nurse and in Nursing Activities Score per nurse.

Citing Articles

"It was simply disturbing" - evaluation of the stress factors of nursing staff on special COVID-19 wards during the pandemic: a qualitative study.

Kiefer L, Volberg C, Graw J, Bosner S BMC Nurs. 2025; 24(1):120.

PMID: 39901241 PMC: 11789282. DOI: 10.1186/s12912-025-02773-y.


Comparison of Nurses' Workload and Multiple Organ Failure of Patients Hospitalized in the COVID-19 and Non-COVID-19 Intensive Care Units.

Moradi M, de Souza Nogueira L, Hanifi N Iran J Nurs Midwifery Res. 2025; 29(6):691-696.

PMID: 39759920 PMC: 11694591. DOI: 10.4103/ijnmr.ijnmr_374_22.


The Impact of Implementing Virtual Diabetes Group Visits on Staff and Provider Wellbeing, Job Satisfaction, and Burnout: A Mixed Methods Analysis.

Moghe R, Zhu M, Staab E, Nunez D, Basheer S, Wan W J Eval Clin Pract. 2024; 31(1):e14238.

PMID: 39600201 PMC: 11599909. DOI: 10.1111/jep.14238.


Clinical characteristics, treatment, and outcomes for elderly patients in a dedicated Covid-19 ward at a primary health care facility in western Norway: a retrospective observational study.

Kittang B, Oien A, Engtro E, Skjellanger M, Kruger K BMC Health Serv Res. 2024; 24(1):1098.

PMID: 39300524 PMC: 11414310. DOI: 10.1186/s12913-024-11539-2.


Impact of healthcare system strain on the implementation of ICU sedation practices and encephalopathy burden during the early COVID-19 pandemic.

Clark J, Batra A, Tessier R, Greathouse K, Dickson D, Ammar A Geroscience. 2024; 47(1):189-203.

PMID: 39243283 PMC: 11872818. DOI: 10.1007/s11357-024-01336-4.


References
1.
Neuraz A, Guerin C, Payet C, Polazzi S, Aubrun F, Dailler F . Patient Mortality Is Associated With Staff Resources and Workload in the ICU: A Multicenter Observational Study. Crit Care Med. 2015; 43(8):1587-94. DOI: 10.1097/CCM.0000000000001015. View

2.
Leng M, Wei L, Shi X, Cao G, Wei Y, Xu H . Mental distress and influencing factors in nurses caring for patients with COVID-19. Nurs Crit Care. 2021; 26(2):94-101. DOI: 10.1111/nicc.12528. View

3.
Padilha K, Stafseth S, Solms D, Hoogendoom M, Monge F, Gomaa O . Nursing Activities Score: an updated guideline for its application in the Intensive Care Unit. Rev Esc Enferm USP. 2016; 49 Spec No:131-7. DOI: 10.1590/S0080-623420150000700019. View

4.
Lucchini A, De Felippis C, Elli S, Schifano L, Rolla F, Pegoraro F . Nursing Activities Score (NAS): 5 years of experience in the intensive care units of an Italian University hospital. Intensive Crit Care Nurs. 2013; 30(3):152-8. DOI: 10.1016/j.iccn.2013.10.004. View

5.
Coppo A, Bellani G, Winterton D, di Pierro M, Soria A, Faverio P . Feasibility and physiological effects of prone positioning in non-intubated patients with acute respiratory failure due to COVID-19 (PRON-COVID): a prospective cohort study. Lancet Respir Med. 2020; 8(8):765-774. PMC: 7304954. DOI: 10.1016/S2213-2600(20)30268-X. View