A neonatal intensive care unit nurse's ability to provide optimal patient care is influenced by a variety of factors --not just how many babies he or she is caring for or how sick they might be, suggests a study in JAMA Pediatrics, which highlights the importance of considering multiple pressures that nurses experience and developing a broader tool kit of workload strategies that enables high-quality nursing care at the bedside.
The study found that a nurse's perception of the difficulty of the work-day --everything from being squeezed for time to the mental pressures of the shift--had a bearing on his or her ability to provide the best care possible, regardless of how many patients the nurse was tending to.
"We were surprised to discover how important subjective workload is to care quality, and it's something we typically don't measure in health care. This is really the nurse's voice telling us how intense things are," says lead researcher Heather Tubbs Cooley, associate professor of nursing and member of the College of Nursing's Center for Women, Children & Youth at Ohio State University, Columbus.
The study includes data collected during 12-hour shifts from neonatal intensive care nurses. During each shift, the researchers collected objective measures of infant-to-nurse staffing ratios and infant acuity--a measure of the severity of a patient's illness. Nurses also filled out a simple questionnaire that measured perceived workload based on mental demand, physical demand, temporal demand (how hurried a nurse felt during a shift), and overall effort needed to accomplish patient care.