Workload of postanaesthesia care unit nurses and intensive care overflow

Abstract

The admission of intensive care unit (ICU) overflow patients in the post anaesthesia care unit (PACU) has come about as a result of an increasing demand for ICU services, which is not followed by a respective increase in the number of available beds. This has raised many concerns from nurses, with extensive workload and lack of personnel being the most important. This study was conducted in the General University Hospital of Patras, Greece, from 1 January 2003 to 30 June 2004. Admissions of ICU patients in the PACU were recorded and Project Research in Nursing (PRN), a Canadian workload measurement system, was used to estimate nursing workload. One hundred and three ICU patients were admitted and they stayed for a total time of 2812 hours. PRN scores of these ICU patients were much higher than for post anaesthesia patients. Clinically important increases of total PRN score, total care time and nursing personnel needs were evident in the presence of an ICU overflow patient during all shifts. Unless there is the appropriate number of personnel, increases in total care time are likely to lead to the neglect of post anaesthesia patients' needs.

Carga de trabalho de enfermagem em unidade de recuperação pós-anestésica

“…(5) In the post-anesthesia care unit of a Greek hospital, the mean severity index as measured by the SAPS II was 29.7%±18.8. (2) In both studies, there was a statistically significant association between severity and nursing workload. (2,5) In the present study, there was no correlation between nursing workload as measured by the NAS and SAPS II severity index.…”

“…(2) In both studies, there was a statistically significant association between severity and nursing workload. (2,5) In the present study, there was no correlation between nursing workload as measured by the NAS and SAPS II severity index. These findings are consistent with the collected data, in that most patients remained clinically stable and were transferred to inpatient units.…”

“…The results of this study highlight the importance of the nursing team in the prevention and management of postoperative complications and provides insight into the nursing activities carried out in the post-anesthesia recovery setting. (1) Surgical complications may be associated with clinical variables, the complexity of surgery, or operative time; (1)(2)(3) these aspects may, in turn, lead to an increase in nursing workload. Studies confirm that the nursing workload in the post-anesthesia care unit is greater when more severely ill patients are present and when the number of adverse events is higher.…”

“…Studies confirm that the nursing workload in the post-anesthesia care unit is greater when more severely ill patients are present and when the number of adverse events is higher. (2,3) Although the postoperative needs of surgical patients are well known, there has been little research into the time spent on provision of postoperative care. In the Brazilian context, knowledge of the adequacy of nursing workload as a function of patient needs in the post-anesthesia care unit is still incipient.…”

Use of Postanesthesia Care Unit for Purposes Other Than Postanesthesia Observation

“…A shortage of ICU beds and nursing personnel may contribute to the use of the PACU for extended recovery units for critically ill patients. 1,7,8 We performed a study to find out the proportion of patients admitted to the PACU for reasons other than postoperative observation and care. Furthermore, we analyzed what kind of resources, observation, and interventions these patients required in PACU facilities.…”