Impact of Wound Dressing Changes on Nursing Workload in an Intensive Care Unit

Abstract

The objective of this study is to understand how the type of wound dressing changes (routine or frequent) in patients admitted to intensive care units influences nurses’ workload. This study used a database of retrospective and analytical observational study from one Portuguese intensive care unit. The sample included 728 adult patients admitted between 2015 and 2019. The nursing workload was assessed by the TISS-28 scale, both at admission and at discharge. The linear regression results show that patients with frequent dressing changes are associated with a higher nursing workload, both at admission (Coef. 1.65; 95% CI [0.53; 2.77]) and discharge (Coef. 1.27; 95% CI [0.32; 2.22]). In addition, age influences the nursing workload; older people are associated with a higher nursing workload (at admission Coef. 0.07; 95% CI [0.04; 0.10]; at discharge Coef. 0.08; 95% CI [0.05; 0.10]). Additionally, an increase in nursing workload at admission would significantly increase the nursing workload at discharge (Coef. 0.27; 95% CI [0.21; 0.33]). The relative stability of the nursing workload over the studied years is also another important finding (the influence of studied years is non-significant). In conclusion, patients with frequent dressing changes presented higher TISS-28 scores when compared with patients with an exchange of routine dressings, which leads to a higher nursing workload.

Evaluation of Tranexamic Acid Application without Closed-Suction Drainage versus with Closed Suction Clamping in Patients Undergoing Knee Arthroplasty: A Retrospective Assessment of Blood Loss and Transfusion

“…The excessive requirement for dressing changes is signi cant in terms of increasing the risk of infection, disrupting wound healing, impacting patient comfort, and also in terms of cost implications [19]. Contrary to our ndings, metaanalyses on the abstention from CSD in TKA surgery have reported an increase in the requirement for dressing changes.…”

Acute care nurses' experience in providing evidence‐based care for patients with laparotomy wounds: A scoping review

“…Practice‐based experience influenced nurses' actions, which showed variations in the care provided with the best current, evidence‐based practice. There was greater value placed on changing wound dressings due to time constraints 67 and habitual practices rather than assessing patients' risk factors affecting wound healing. 35 The accessibility to an assessment tool that aligns with a specific wound management plan would ensure continuity of care by prompting the required documentation information.…”

“…Intensive care nurses and wound care specialists outside of ward settings similarly reflected on the benefits of an improved understanding of physiological processes related to wound deterioration. 67 , 82 Whereas the Vietnamese nurses focused on the environmental context and resources, recognising the impact the clinical setting poses to infection prevention control in shared patient spaces. This finding complements nurses' experiences from other developing countries, who reported the need for improved access to personal protective equipment and a clean ward setting, commonly available in tertiary but not primary care settings.…”