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Nursing workload and patient-focused outcomes in intensive care: A systematic review |
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| Authors: | Paul Ross RN BHSc(Nur) PGCert ICU MN(Research) Med(Adult) Bethany Howard BESS(Hons) Dragan Ilic BSc Grad Dip Rep Sci MSc PhD GCHPE Jason Watterson RN BHSc(Nur) PGDipAdvNur(CritCare) Med(Adult) PhD Carol L. Hodgson PhD PT M(Phil) |
| Affiliation: | 1. Department of Intensive Care, Alfred Health, Commercial Road, Melbourne, Victoria, Australia;2. Medical Education Research & Quality (MERQ), School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia;3. Medical Education Research & Quality (MERQ), School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia Contribution: Conceptualization, Investigation, Writing - original draft, Methodology, Validation, Visualization, Writing - review & editing, Software, Formal analysis, Project administration, Data curation, Supervision, Resources;4. Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia |
| Abstract: | The aim of this systematic review was to examine the association of nursing workload on patient outcomes in intensive care units. The primary outcome measure was patient mortality, with adverse events (AE), the secondary outcome measures. Electronic search of databases including MEDLINE, CINAHL, Cochrane, EMCARE, Scopus, and Web of Science were performed. Studies were excluded if they were in non-ICU settings, pediatric, neonatal populations, or if the abstract/full text was unavailable. Risk of bias was assessed by the ROBINS-I tool. After screening 4129 articles, 32 studies were identified as meeting inclusion criteria. The majority of included studies were assessed as having a moderate risk of bias. The nursing activities score (NAS) was the most frequently used tool to assess nursing workload. Our systematic review identified that higher nursing workload was associated with patient-focused outcomes, including increased mortality and AE in the intensive care setting. The varied approaches of measuring and reporting nursing workload make it difficult to translate the findings of the impact of nursing workload on patient outcomes in intensive care settings. |
| Keywords: | intensive care units mortality nurses nursing patient safety quality of health care workload |