Patients’ Characteristics and Healthcare Providers’ Perceived Workload in French Hospital Emergency Wards

Schoenenberger, Sandrine; Moulin, Pierre; Brangier, Éric; Gilibert, Daniel

doi:10.1080/10803548.2014.11077071

Cited by 6 publications

(6 citation statements)

References 18 publications

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“…[ 9 , 36 ] Notably, the findings of the present study are in contrast to the results of Schoenenberger and co-workers who found physical demands to be the factor that is most influenced by patient characteristics which–in our study–should be reflected by the NACA score. [ 16 ] According to Leedal and Smith’s review, however, physiological workload indicators do not necessarily correlate with workload, since their use is based on the assumption that changes in workload causes changes to the body. [ 2 ]…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, there seems to be further need for training of pediatric emergencies embedded in the emergency physician’s curriculum since they cause high levels of strain. [ 16 – 18 ] Nevertheless, it has to be pointed out that CPR is an independent category in the NACA scoring system, whereas the medical condition of children during emergency care may range from NACA I to NACA VII. Hence, further research on the correlation of briefing-alarm codes and NACA scores as well as physicians’ workload is needed.…”

Section: Discussionmentioning

confidence: 99%

“…[ 9 ] Our recent work indicated that non-linear HRV metrics can also distinguish workload levels during pre-hospital emergency care. [ 15 ] However, though excessive workload may impair patient safety,[ 16 – 18 ] data on workload during pre-hospital care including cardiopulmonary resuscitation (CPR) are still scarce.…”

Section: Introductionmentioning

confidence: 99%

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The impact of the patient’s initial NACA score on subjective and physiological indicators of workload during pre-hospital emergency care

et al. 2018

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BackgroundExcessive workload may impair patient safety. However, little is known about emergency care providers’ workload during the treatment of life-threatening cases including cardiopulmonary resuscitation (CPR). Therefore, we tested the hypothesis that subjective and physiological indicators of workload are associated with the patient’s initial NACA score and that workload is particularly high during CPR.MethodsNASA task load index (NASA-tlx) and alarm codes were obtained for 216 sorties of pre-hospital emergency medical care. Furthermore, initial NACA scores of 140 patients were extracted from the physicians’ protocols. The physiological workload indicators mean heart rate (HR) and permutation entropy (PeEn) were calculated for 51 sorties of primary care. General linear mixed models were used to analyze the association of NACA scores with subjective (NASA-tlx) and physiological (mean HR, PeEn) measures of workload.ResultsIn contrast to the physiological variables PeEn (p = 0.10) and HR (p = 0.19), the mental (p<0.001) and temporal demands (p<0.001) as well as the effort (p<0.001) and frustration (p = 0.04) subscale of the NASA-tlx were significantly associated with initial NACA scores. Compared to NACA = I, an initial NACA score of VI (representing CPR) increased workload by a mean of 389.5% (p = 0.001) in the mental and 345.9% (p<0.001) in the temporal demands, effort by a mean of 446,8% (p = 0.002) and frustration by 190.0% (p = 0.03). In line with the increase in NASA-tlx, PeEn increased by 20.6% (p = 0.01) and HR by 6.4% (p = 0.57).ConclusionsPatients’ initial NACA scores are associated with subjective workload. Workload was highest during CPR.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The impact of the patient’s initial NACA score on subjective and physiological indicators of workload during pre-hospital emergency care

et al. 2018

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“…Mental workload implies a weight, a cost, and a quantity of effort that one feels while completing a task. 1 It increases when an individual is in a complex working environment, unfamiliar with the task, faces a highly technical requirement task, and works for a long time. 2 A high level of mental workload among HCWs aggravates their sense of fatigue, decreases their learning ability, and increases their work pressure.…”

Section: Introductionmentioning

confidence: 99%

Frontline Health Care Workers’ Mental Workload During the COVID-19 Pandemic: A Cross-Sectional Study

2021

Asia Pac J Public Health

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Workload is an essential factor affecting the performance of health care workers (HCWs). High level of mental workload increased their risks of insomnia, anxiety, and depression. This study committed to investigate frontline HCWs’ mental workload and analyze its influencing factors during the novel coronavirus disease 2019 (COVID-19) pandemic. A total of 802 frontline HCWs completed the online questionnaires. Their total mental workload score was 69.7 ± 16.4. Frontline HCWs were satisfied with their performance (4.0 ± 3.3) and showed a low level of frustration (8.3 ± 5.7). The most important dimensions of mental workload were “effort” (16.4 ± 13.7), “physical demand” (15.7 ± 4.7), and “mental demand” (12.9 ± 5.2). Frontline nurses and HCWs who have higher education level, longer working years, and higher professional title perceived higher mental workload scores ( P < .05). In conclusion, frontline HCWs’ mental workload was not high as seen during the COVID-19 pandemic in China. They have made tremendous efforts and dedication to caring for COVID-19 patients. Job-related factors, some of which can be eliminated by proper management skills, increased frontline HCWs mental workload.

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“…Accordingly, the emergency room (ER) has been described as an unpredictable and unstable work environment where physicians are exposed to high amounts of workload. [ 18 , 19 ] Hence, with respect to objective measures of workload, it is necessary to extend the research to work environments outside the highly-standardized settings of the operation theatre.…”

Section: Introductionmentioning

confidence: 99%

The validity of linear and non-linear heart rate metrics as workload indicators of emergency physicians

et al. 2017

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BackgroundIt has been shown that linear and non-linear heart rate variability (HRV) metrics are suitable to assess workload of anesthetists administering anesthesia. In pre-hospital emergency care, these parameters have not yet been evaluated. We hypothesized that heart rate (HR) and HRV metrics discriminate between differing workload levels of an emergency physician.MethodsElectrocardiograms were obtained from 13 emergency physicians. Mean HR, ten linear and seven non-linear HRV metrics were analyzed. For each sortie, four different levels of workload were defined. Mixed-effects models and the area under the receiver operating characteristics curve (AUC) were used to test and quantify the HR and HRV metrics’ ability to discriminate between levels of workload. This was conducted for mean HR and each HRV metric as well as for groups of metrics (time domain vs. frequency domain vs. non-linear metrics).ResultsThe non-linear HRV metric Permutation entropy (PeEn) discriminated best between the time before the alarm and primary patient care (AUC = 0.998, 1st rank of 18 HRV metrics). In contrast, AUC of the mean HR was low (0.558, 17th rank). In the multivariable approach, the non-linear HRV metrics provided a higher AUC (0.998) compared to the frequency domain (0.677) and to the time domain metrics (0.680).ConclusionNon-linear heart rate metrics and, specifically, PeEn provided good validity for the assessment of different levels of a physician’s workload in the setting of pre-hospital emergency care. In contradiction to earlier findings, the physicians’ mean HR was not a valid marker of workload.

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Patients’ Characteristics and Healthcare Providers’ Perceived Workload in French Hospital Emergency Wards

Abstract: workload evaluation emergency ward healthcare providers patients' characteristics NASA-TLX

Cited by 6 publications

References 18 publications

The impact of the patient’s initial NACA score on subjective and physiological indicators of workload during pre-hospital emergency care

The impact of the patient’s initial NACA score on subjective and physiological indicators of workload during pre-hospital emergency care

Frontline Health Care Workers’ Mental Workload During the COVID-19 Pandemic: A Cross-Sectional Study

The validity of linear and non-linear heart rate metrics as workload indicators of emergency physicians

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