Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
Critical Care and Emergency Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt.
Nurs Crit Care. 2023 Nov;28(6):902-912. doi: 10.1111/nicc.12907. Epub 2023 Apr 1.
The overwhelming number of patients admitted to intensive care units (ICUs) combined with a nursing staff deficit sometimes requires the redeployment of nurses from other areas, meaning non-critical care nurses are asked to assist in treating critically ill patients. This may affect patient safety, especially in poorly resourced ICUs with financial constraints, such as in some developing countries. Nurses and nurse managers need specific strategies to address this issue and ensure patient safety.
To explore ICU and floating nurses' perspectives of the floating experience and describe how the use of floating nurses could threaten the safety of patients in Egyptian ICUs.
This was a qualitative descriptive study. Data were collected in in-depth interviews and analysed using Colaizzi's method of analysis. Forty-seven interviews were conducted, 22 with ICU nurses/managers and 25 with floating nurses.
Two main themes were extracted: (1) Lived work experience of floating and ICU nurses during the floating period which included three subthemes: Being a floating nurse: living a double experience of a professional role, Being an ICU nurse: feeling overloaded, and small failures leading to bigger, more serious issuses; and (2) Messages for patient safety from floating and ICU nurses' perspectives which also comprised three subthemes: education and training, putting the patient in the safety zone, and poilcy reform.
Promising strategies for ICUs to ensure patient safety when transferring nurses from other units include providing ongoing education and appropriate training for floating nurses to put patients in the safety zone.
Our findings provide a foundation for nursing practitioners, managers, and policymakers to prevent medical errors and optimize nursing workforce allocation. Nursing managers should consider floating nurses' competence levels when assigning ICU patients. Moreover, teamwork and communication between ICU nurses/managers and floating nurses should be strengthened. Close supervision and use of technology to minimize medical errors are potential strategies to ensure patient safety when using floating nurses.
大量入住重症监护病房（ICU）的患者与护理人员短缺相结合，有时需要从其他领域重新调配护士，这意味着需要非重症护理护士协助治疗重症患者。这可能会影响患者安全，尤其是在资源匮乏且存在财务限制的 ICU 中，例如在一些发展中国家。护士和护士长需要采取具体策略来解决这个问题，确保患者安全。
探讨 ICU 护士和流动护士对流动经验的看法，并描述在埃及 ICU 中使用流动护士如何威胁患者安全。
这是一项定性描述性研究。通过深入访谈收集数据，并使用 Colaizzi 的分析方法进行分析。共进行了 47 次访谈，其中 22 次与 ICU 护士/护士长进行，25 次与流动护士进行。
提取出两个主要主题：（1）流动护士和 ICU 护士在流动期间的真实工作经验，包括三个子主题：作为流动护士：体验双重专业角色，作为 ICU 护士：感到负担过重，小失误导致更大、更严重的问题；（2）来自流动护士和 ICU 护士视角的关于患者安全的信息，也包括三个子主题：教育和培训，将患者置于安全区域，以及政策改革。
当从其他科室转来护士时，为确保 ICU 患者安全，可为流动护士提供持续的教育和适当的培训，将患者置于安全区域。
我们的研究结果为护理从业人员、管理人员和政策制定者提供了基础，以防止医疗错误并优化护理人员配置。护理管理人员在为 ICU 患者分配流动护士时，应考虑流动护士的能力水平。此外，应加强 ICU 护士/护士长和流动护士之间的团队合作和沟通。密切监督和使用技术来最大限度地减少医疗错误是确保使用流动护士时患者安全的潜在策略。
