ICU Nursing Workload Causes and Consequences

描述(由申请人提供)：当今重症监护病房(ICU)最重要的问题之一是护理工作量大。拟议研究的总体目标是检查高护理工作量对ICU护士和患者的影响。为了达到总体目标，本研究提出了护理工作量的概念模型，该模型包括四个主要要素：工作障碍和促进者；工作量；工作生活质量(QWL)；感知护理质量和安全。工作障碍正在抑制直接工作环境中的工作因素，而工作促进者正在促进直接工作环境中的工作因素。概念模型被用作实现从总体目标派生的两个特定目标的指南。第一个目的是调查工作障碍和促进者对ICU护理工作量的影响。工作系统中的一系列障碍可能会导致ICU的护理工作量较大。确定这些障碍和促进者是至关重要的，以便正确地将努力集中在ICU重新设计项目中，该项目旨在通过消除这些障碍和增加促进者来减少护理工作量。第二个目的是检查工作量对ICU护士的生活质量和护理质量和安全性的影响。研究将分两个阶段进行。第一阶段包括为ICU护士编制和试行工作障碍和促进者问卷。这份问卷将用于研究的第二阶段。第二阶段使用横断面设计，以评估工作障碍和促进者对护理工作量、QWL和感知护理质量和安全的影响。拟议的研究将填补一般医疗保健文献中的一个很大空白，特别是在ICU文献中，缺乏调查系统级因素(工作障碍和促进器)对护理工作量、QWL以及护理质量和安全的影响的研究。

DESCRIPTION (provided by the applicant): One of the most important problems in today's intensive care units (ICUs) is high nursing workload. The overall objective of the proposed research is to examine the impact of high nursing workload on ICU nurses and patients. In order to achieve its overall objective, this research study proposes a conceptual model of nursing workload that includes four main elements: work obstacles and facilitators; workload; quality of working life (QWL); and perceived quality and safety of care. Work obstacles are inhibiting work factors in the immediate work setting, and work facilitators are facilitating work factors in the immediate work setting. The conceptual model is used as a guide to accomplish two specific aims derived from the overall objective. The first aim is to investigate the impact of work obstacles and facilitators on nursing workload in ICUs. A range of obstacles in the work system may contribute to high nursing workload in an ICU. Identifying these obstacles and facilitators is crucial in order to correctly focus efforts in an ICU redesign project that aims at reducing nursing workload by eliminating these obstacles and increasing facilitators. The second aim is to examine the impact of workload on QWL and perceived quality and safety of care among ICU nurses. The study will be conducted in two phases. The first phase includes the development and pilot testing of the work obstacles and facilitators questionnaire for ICU nurses. This questionnaire will be used in the second phase of the study. The second phase uses a cross-sectional design in order to assess the impact of work obstacles and facilitators on nursing workload, QWL and perceived quality and safety of care. The proposed research will fill a large gap in the health care literature in general and in the ICU literature in particular in which there is a lack of studies that investigate the impact of system-level factors (work obstacles and facilitators) on nursing workload, QWL, and quality and safety of care.