Nursing Activities Score is increased in COVID-19 patients

Lucchini, Alberto; Giani, Marco; Elli, Stefano; Villa, Silvia; Rona, Roberto; Foti, Giuseppe

doi:10.1016/j.iccn.2020.102876

Cited by 127 publications

(133 citation statements)

References 7 publications

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“…In a study by Lucchini et al, a 33% increase was indicated in the nursing workload among those who worked with COVID-19 patients in ICU. The authors suggested their colleagues worldwide to make an effort to increase the ICU nursing staff, to start training registered nurses from general wards to perform basic ICU procedures, and to dedicate intensive care nurses to manage more complex procedures, in order to be prepared to face the epidemic [14]. During the COVID-19 pandemic, it was shown that healthcare workers are at a higher risk of exposure, so the application of personal protective equipment (PPE) is necessary.…”

Section: Resultsmentioning

confidence: 99%

Covid-19 effects on the workload of Iranian healthcare workers

Shoja

Aghamohammadi

Bazyar

et al. 2020

Preprint

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Background: In this study, we aimed to evaluate the impact of the COVID-19 epidemic on the workload and mental health of Iranian medical staff using the General Health Questionnaire (GHQ-12) and NASA -Task Load Index (NASA-TLX) Questionnaire between March and April 2020, respectively.Methods: The present cross-sectional study was conducted from March 5th to April 5th, 2020. To evaluate the workload and mental health of participants NASA-TLX and GHQ-12 online questionnaires were distributed. Data were entered into software SPSS (Version 23) and T-test, ANOVA, Regression methods were used for data analysis.Results: Health workers who encountered COVID- 19 patients, were subjected to more task load compared to those who had no contact with COVID- 19 patients at the workplace (p<0.001). In terms of the subscale score of NASA-TLX, nurses had more scores in mental pressure, physical pressure, time pressure(temporal), and frustration compared to the other jobs (p<0.05). Moreover, nurses had significantly more workload compared to the other jobs.Conclusions: Type of job, the shift of work, educational level, and facing COVID-19 affected the score of NASA-TLX. NASA-TLX scores were higher in nursing compared to the scores of other health staff groups. The results of this study indicate that the scores of NASA-TLX and GHQ-12 among staff who had contact with COVID-19 patients were significantly higher than those who did not face COVID-19 patients. We suggested that a comprehensive assistance should be provided to support the well-being of healthcare workers especially nurses and healthcare workers who treated COVID-19 patients.

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Section: Resultsmentioning

confidence: 99%

Covid-19 effects on the workload of Iranian healthcare workers

Shoja

Aghamohammadi

Bazyar

et al. 2020

Preprint

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“…This may be related to the increased workload involved in the care of patients with COVID-19. Lucchini et al (2020) report a 33% increase in CCU workload, with mean scores of 84 on the Nursing Activities Score (NAS), well above the normal value of 63, due to the high number of patients dependent on mechanical ventilation, indications for prone positioning, time spent putting on and taking off PPE, and indications for extracorporeal life support techniques. Lucchini et al (2020) also report on the need to ensure nurse-patient ratios of 1:1.5.…”

Section: Discussionmentioning

confidence: 99%

“… Lucchini et al (2020) report a 33% increase in CCU workload, with mean scores of 84 on the Nursing Activities Score (NAS), well above the normal value of 63, due to the high number of patients dependent on mechanical ventilation, indications for prone positioning, time spent putting on and taking off PPE, and indications for extracorporeal life support techniques. Lucchini et al (2020) also report on the need to ensure nurse-patient ratios of 1:1.5. In addition, the Spanish Society of Intensive Nursing and Coronary Units (SEEIUC) recommends a ratio of 1:2 (the usual average nurse-patient ratio prior to the COVID-19 pandemic was 1:2.5) ( Cruz-Lendínez et al, 2019 ), with 1 expert nurse for every 4-6 beds to provide support at times of peak workload, and points out that a NAS greater than 61 increases the risk of patient mortality ( Raurell-Torredà et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Nurses’ perceptions and demands regarding COVID-19 care delivery in critical care units and hospital emergency services

González-Gil

González-Blázquez

Moreno

et al. 2021

Intensive and Critical Care Nursing

203

226

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Highlights Critical care nurses have had to perform tasks for which they have not received proper training. Nurses have had to manage the fear of becoming infected and spreading it to their families. Moral suffering and emotional exhaustion are major consequences of front-line care. Heavy workloads, high patient-nurse ratios, and lack of rest are causing exhaustion among nurses.

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“…The impact of COVID-19 on the NAS was analysed in a preliminary Italian study of the first 15 patients admitted to the ICU. Significantly higher NAS was observed in the COVID-19 group (M=84 ± 10), compared to the non-COVID-19 group (M=63 ± 15) ( Lucchini et al, 2020 ). However, this first study was carried out with a small cohort of patients, in a single ICU, and for a limited time.…”

Section: Introductionmentioning

confidence: 94%

“…COVID-19 ICU patients regularly require mechanical ventilation in the prone position, or even extracorporeal membrane oxygenation (ECMO) ( Elharrar et al, 2020 , Grasselli et al, 2020 ). This significant increase in critically ill patients influences the nursing workload in the ICU ( Lucchini et al, 2020 ) and optimal management of the nurse-patient (N:P) ratio is essential in order to ensure the quality and safety of care. Indeed, studies have demonstrated an association between inadequate N:P ratio and hospital mortality ( Aiken et al, 2014 , Margadant et al, 2020 , Needleman et al, 2020 , Neuraz et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Impact of COVID-19 on nursing time in intensive care units in Belgium

Bruyneel

Gallani

Tack

et al. 2021

Intensive and Critical Care Nursing

123

107

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Introduction The COVID-19 pandemic has had a significant impact on nursing practice in intensive care unit (ICU) and, consequently, on workload. Objective To assess the nurse-patient (N:P) ratio required by COVID-19 patients and to identify the factors that influence nursing in this context. Design This study was a retrospective observational study that evaluated the N:P ratio using the Nursing Activities Score (NAS). Setting Three Belgian French-speaking hospitals, including five ICUs. Patients included COVID-19 and non-COVID-19 patients in the ICU. Measurements and Main Results The study included 95 COVID-19 patients and 1,604 non-COVID-19 patients (control group) resulting in 905 and 5,453 NAS measures, respectively. The NAS was significantly higher among the COVID-19 patients than in the control group (p=<0.0001). In the COVID-19 group, these higher scores were also observed per shift and uniformly across the three hospitals. COVID-19 patients required more time in the activities of monitoring and titration (χ2= 457.60, p=<0.0001), mobilisation (χ2= 161.21, p=<0.0001), and hygiene (χ2= 557.77, p=<0.0001). Factors influencing nursing time measured by NAS in the COVID-19 patients were age < 65 years old (p=0.23), the use of continuous venovenous hemofiltration (p=0.002), a high APACHE II score (p=0.006), and patient death (p=0.002). A COVID-19 diagnosis was independently associated with an increase in nursing time (OR=4.8, 95% CI:3.6-6.4). Conclusions Patients hospitalised in the ICU due to COVID-19 require significantly more nursing time and need an average N:P ratio of almost 1:1.

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Nursing Activities Score is increased in COVID-19 patients

Cited by 127 publications

References 7 publications

Covid-19 effects on the workload of Iranian healthcare workers

Covid-19 effects on the workload of Iranian healthcare workers

Nurses’ perceptions and demands regarding COVID-19 care delivery in critical care units and hospital emergency services

Impact of COVID-19 on nursing time in intensive care units in Belgium

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