Ross Paul, Howard Bethany, Ilic Dragan, Watterson Jason, Hodgson Carol L
Department of Intensive Care, Alfred Health, Commercial Road, Melbourne, Victoria, Australia.
Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Nurs Health Sci. 2023 Dec;25(4):497-515. doi: 10.1111/nhs.13052. Epub 2023 Oct 2.
The aim of this systematic review was to examine the association of nursing workload on patient outcomes in intensive care units. The primary outcome measure was patient mortality, with adverse events (AE), the secondary outcome measures. Electronic search of databases including MEDLINE, CINAHL, Cochrane, EMCARE, Scopus, and Web of Science were performed. Studies were excluded if they were in non-ICU settings, pediatric, neonatal populations, or if the abstract/full text was unavailable. Risk of bias was assessed by the ROBINS-I tool. After screening 4129 articles, 32 studies were identified as meeting inclusion criteria. The majority of included studies were assessed as having a moderate risk of bias. The nursing activities score (NAS) was the most frequently used tool to assess nursing workload. Our systematic review identified that higher nursing workload was associated with patient-focused outcomes, including increased mortality and AE in the intensive care setting. The varied approaches of measuring and reporting nursing workload make it difficult to translate the findings of the impact of nursing workload on patient outcomes in intensive care settings.
本系统评价的目的是研究重症监护病房护理工作量与患者预后之间的关联。主要结局指标是患者死亡率，次要结局指标是不良事件（AE）。对包括MEDLINE、CINAHL、Cochrane、EMCARE、Scopus和Web of Science在内的数据库进行了电子检索。如果研究处于非重症监护病房环境、儿科或新生儿人群中，或者摘要/全文不可用，则将其排除。采用ROBINS-I工具评估偏倚风险。在筛选了4129篇文章后，确定有32项研究符合纳入标准。大多数纳入研究被评估为具有中度偏倚风险。护理活动评分（NAS）是评估护理工作量最常用的工具。我们的系统评价发现，在重症监护环境中，较高的护理工作量与以患者为中心的结局相关，包括死亡率增加和不良事件。测量和报告护理工作量的方法各不相同，这使得难以将护理工作量对重症监护环境中患者结局影响的研究结果进行转化。
