Sensor-based measurement of critical care nursing workload: Unobtrusive measures of nursing activity complement traditional task and patient level indicators of workload to predict perceived exertion
Sensor-based measurement of critical care nursing workload: Unobtrusive measures of nursing activity complement traditional task and patient level indicators of workload to predict perceived exertion
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DOI：
10.1371/journal.pone.0204819
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发表时间：
2018-10-12
期刊：
影响因子：
3.7
通讯作者：
Pronovost, Peter J.
中科院分区：
文献类型：
--
作者：
Rosen, Michael A.;Dietz, Aaron S.;Pronovost, Peter J.
目的探讨基于传感器的工作流程测量方法在预测重症护理护士身心消耗感知方面的有效性。材料和方法重复测量混合方法在外科重症监护病房的研究。可穿戴和环境传感器捕获工作过程数据。护士对每4小时的精神（ME）和体力消耗（PE）进行评分，并记录患者和医护人员的工作量因素。Shift是多水平模型中的分组变量，其中基于传感器的测量方法用于预测护理对劳累的感知。结果35个床边护理班共89个4小时轮班共356个工作小时。在最终模型中，基于传感器的数据占ME的移位间方差的73%，移位内方差的5%；以及55%的移位间方差和55%的移位内方差。ME的显著预测因子包括病房噪音（beta = 0.30, p < 0.01）、在主要工作区域以外花费的时间与活动水平之间的相互作用（beta = 2.24, p < 0.01）、注射胰岛素的患者数量与说话急促之间的相互作用（beta = 0.19, p < 0.01）
ObjectiveTo establish the validity of sensor-based measures of work processes for predicting perceived mental and physical exertion of critical care nurses.Materials and methodsRepeated measures mixed-methods study in a surgical intensive care unit. Wearable and environmental sensors captured work process data. Nurses rated their mental (ME) and physical exertion (PE) for each four-hour block, and recorded patient and staffing-level workload factors. Shift was the grouping variable in multilevel modeling where sensor-based measures were used to predict nursing perceptions of exertion.ResultsThere were 356 work hours from 89 four-hour shift segments across 35 bedside nursing shifts. In final models, sensor-based data accounted for 73% of between-shift, and 5% of within-shift variance in ME; and 55% of between-shift, and 55% of within-shift variance in PE. Significant predictors of ME were patient room noise (beta = 0.30, p < .01), the interaction between time spent and activity levels outside main work areas (beta = 2.24, p < .01), and the interaction between the number of patients on an insulin drip and the burstiness of speaking (beta = 0.19, p