Nursing workload in burn intensive care unit

To measure the nursing workload in the Burn Intensive Care Units and evaluate its association with clinical variables, length of stay, and outcome of hospitalization.

Methods:

Cross-sectional study carried out in a Brazilian public large hospital. The study included 33 patients. The nursing workload was assessed using the Nursing Activities Score (NAS) every 24 hours. We performed 447 Nursing Activities Score assessments. For the statistical analysis, Student’s t-test, ANOVA, and Spearman’s correlation test were used. The considered significant difference was 5% (p ≤ 0.05).

Results:

The Nursing Activities Score mean was 84% (± 4.4), which corresponded to 20.2 hours. There was an association between the nursing workload and the patient’s severity (p <0.010), burned body surface (p = 0.010), and hospitalization outcome (p = 0.020).

Conclusion:

Burn victims, assisted in the ICU, demanded a high nursing workload, which was influenced by clinical aspects and the hospitalization outcome. These findings point to the need to reconsider the nurse staffing related to this care profile.

Descriptors:
Workload; Nursing; Intensive Care Unit; Burns; Burn Units

NAS Items	n	%
1. Monitoring and control	447	100
2. Laboratory investigations	447	100
3. Medication (except vasoactive drug)	447	100
4. Hygiene procedures	447	100
5. Drain care (except gastric tube)	258	58
6. Mobilization and positioning	447	100
7. Support and care for family members and patients	447	100
8. Administrative and managerial tasks	447	100
9. Ventilatory support	211	47
10. Care of artificial airways	274	61
11. Treatment for improving lung function	366	82
12. Vasoactive medication	179	40
13. Intravenous replacement of large fluid losses	270	60
16. Hemofiltration technique	40	9
17. Quantitative measurement of urine output	447	100
21. Enteral nutrition	337	75
22. Specific interventions in the ICU	51	11
23. Specific interventions outside the ICU	83	18

Variables	NAS mean (%)	SD (%)	p value
Intubation			0,310Ω
No	81	3,4
Yes	84	4,1
Use of vasoactive drugs			0,240 Ω
No	81	3,4
Yes	85	4,3
Hospitalization outcome			0,020*β
Discharge	81	3,1
Death	86	5,0
Body burned area			0,010*β
Major burn	85	4,3
Moderate burn	81	4,3
Minor burn	80	1,5

Variables	R	p value
NAS × Severity - SAPS 3	0,47	< 0,001^* * Spearman's correlation, statistical significance of p ≤ 0.05; NAS = Nursing Activities Score.
NAS × Length of stay	-0,10	0,550

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[1] Corresponding author: Armando dos Santos Trettene E-mail: armandotrettene@usp.br