The continuing imperative to measure workload in ICU: impact on patient safety and staff well-being

The characterisation of workloads and nursing staff allocation in intensive care units: A descriptive study using the Nursing Activities Score for the first time in Norway

“…Our study found nurse staffing costs per 1% NAS to be quite similar in all four ICUs. The NAS offers an indicator of staffing needs and is more relevant to nursing workload than staffing based simply on the number of admitted patients or LOS (Endacott, 2012;Miranda and Jegers, 2012;Araújo et al, 2016). Our main findings, using nurse staffing costs in 2012 show that it is possible to describe costs in relation to patients' care needs and interventions.…”

“…Benchmarking includes identifying the best practice measurement associated with a given quality or outcome (Finkler and McHugh, 2008). An analysis of human resource operating costs is needed within an ICU to determine if resources are properly allocated according to individual needs (Endacott, 2012;Wunsch et al, 2012). Labour costs are the most important cost driver and in a group of four European countries, the United Kingdom showed the highest labour costs relative to total ICU costs (Tan et al, 2012); this was due to the higher unit costs of ICU specialists and ICU nurses.…”

“…Cost is connected to numbers of staff and simplified staffing parameters, such as nurse-to-patient ratio, were widely used in earlier times. However, a more precise method than nurse-to-patient ratio is needed to assess and monitor patients' needs and to classify nursing activities and specific interventions (Endacott, 2012;Wunsch et al, 2012;West et al, 2014 Classification systems measure patient illness severity and classify nursing activities into direct and indirect care. These have been used to quantify clinical performance and to explore the effects of workload on nurse sensitive patient outcomes (Miranda and Jegers, 2012;Kakushi and Martinez Evora, 2014;Lindqvist et al, 2014).…”

The culture of patient safety in an Iranian intensive care unit

“…). In addition, heavy workload, fatigue and stress adversely affect both patient safety and staff well‐being in the ICUs (Endacott ).…”

Approaches to decreasing medication and other care errors in the ICU

“…Excessive workload and working hours, shortness of sleep, and fatigue reduce the performance of healthcare personnel [34,35], and hence most likely patient safety as well [36]. In a recent study [37], post-call assessment of junior hospital doctors after extended work shifts (average 32.75 h) showed a significant decline in cognitive functioning and clinical decision making performance.…”