Comparison of workloads in two nursing care delivery models in adult intensive care units
DOI:
https://doi.org/10.15649/cuidarte.4510Keywords:
Critical Care Nursing, Hospital Nursing Staff, Nurses, Nursing Assistants, WorkloadAbstract
Highlights
- The Therapeutic Intervention Scoring System (TISS-28) revealed that the nursing staff was insufficient to meet the care requirements of the patients.
- There is a direct correlation between the workload quantified by the TISS-28 and the development of adverse events, the proportion of deaths, and hospital stays longer than 7 days.
- Direct care by nurses showed a lower proportion of adverse events and shorter hospital stays compared to the direct care model by nursing assistants.
- Some functions delegated to nursing assistants in the direct care model by nursing assistants do not correspond to their technical and legal competence.
Introduction: Work overload is associated with missed care and a higher prevalence of adverse events. The study aims to generate empirical evidence on nursing workload in intensive care units in Colombia, considering differences in team composition based on qualifications, skills, and competencies (Skill Mix). Objective: To compare the workload and distribution of nursing activities in two intensive care units with different Nursing Care Models based on the application of the TISS-28. Materials and Methods: Quantitative and retrospective study with data from medical records of patients treated between 2018 and 2020 in Medellín. The TISS-28 was calculated upon admission and SAPS-3 was used to control for confounding variables. Mean and proportion comparison tests were used according to the type of variable and data distribution pattern. Results: The nurses in both ICUs had a patient assignment higher than indicated by the TISS-28. Surgical patients, those with vasoactive drugs, transfusions, adverse events, or those who died, had longer care times. The adverse events increased proportionally with the TISS-28 level. Discussion: Key elements include the relationship between care safety and staff qualification, experience and workload; the missed nursing care; and the undervaluation of care as a public good. Conclusions: It was identified that in both ICUs there is a higher workload for nurses regarding the time available for activities and patients. The majority of care provided by the nursing assistants in the ICU2-Assistants do not correspond with their level of training and legal responsibility.
How to cite this article: Rojas Cárdenas Katherine, López Cárdenas William Iván, Henao Murillo Natalia Andrea. Comparison of workloads in two nursing care models in adult intensive care units. Revista Cuidarte. 2025;16(3):e4510. https://doi.org/10.15649/cuidarte.4510
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