Carga de trabalho e dimensionamento de enfermagem no cuidado ao paciente crítico com COVID-19
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Data
2022-03-17
Autores
Grassi, Mariana de Freitas [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Introdução: A mensuração da carga de trabalho da enfermagem possibilita identificar as necessidades de cuidado do paciente e pode influenciar no dimensionamento da equipe de enfermagem e alocação de recursos humanos, visando segurança e satisfação do paciente. Há evidências de aumento da carga de trabalho da enfermagem em pacientes com diagnóstico de COVID-19 em cuidados críticos. Objetivo: Comparar a carga de trabalho, dimensionamento e absenteísmo da enfermagem, na assistência entre pacientes internados em unidades de cuidados críticos no período pré pandemia e durante a pandemia. Métodos: Estudo transversal, retrospectivo, a partir de dados secundários, coletados no período de 24/02/2019 a 24/02/2021. Resultados: São apresentados três artigos: (1) Carga de trabalho de enfermagem na pandemia por COVID-19: uma revisão de escopo. Foram identificados 1.120 estudos e incluídos oito. A gravidade dos pacientes com COVID-19 impactou as instituições frente a crise de recursos humanos, houve aumento da carga de trabalho da enfermagem. (2) Comparação da carga de trabalho pelo Nursing Activities Score e dimensionamento de enfermagem antes e durante a pandemia por COVID-19 em unidades de cuidados críticos. Foi identificado aumento significativo do NAS em 4,2 pontos no período pandêmico; (3) Impacto da pandemia por COVID-19 no absenteísmo da equipe de enfermagem em terapia intensiva. Foi identificado o aumento na média de afastamentos entre equipe de enfermagem. Doenças infecciosas e parasitárias foram prevalentes (23%) nos motivos de afastamento no período pandêmico, ocorreram cinco vezes mais comparado ao período pré-pandemia. Infeção por COVID-19 foi principal causa de afastamentos (13,4%) no período de pandemia. Implicações para a prática clínica: Foi possível analisar os impactos gerenciais e assistenciais da pandemia por COVD-19 nas unidades críticas em que houve a necessidade de se adequar para atender a população ao reorganizar a estrutura de unidades de cuidados críticos, expansão no número de leitos, contratações e adequação de pessoal de enfermagem. Considerações finais: O escore mensurado pelo NAS obteve elevação e diferença estatística entre os períodos pré pandêmicos e pandêmicos. Em relação ao dimensionamento de pessoal fez se necessário a contratação emergencial e realocação da equipe para atender as demandas nas unidades críticas, seguindo as normativas atuais. O absenteísmo-doença no período pandêmico apresentou aumento significativo e alta taxa de contaminação por COVID-19 entre os profissionais, bem como, o aumento de faltas injustificadas da equipe. Os achados deste estudo contribuem à enfermagem ao permitir compreender a magnitude de escores utilizados na prática assistencial e sua implicação na gestão de pessoas e, consequentemente, melhores condições de trabalho
Introduction: The measurement of nursing workload enables the identification of patients' care needs and may influence the dimensioning of the nursing team and allocation of human resources, aiming at patient safety and satisfaction. There is evidence of increased nursing workload in patients diagnosed with COVID-19 in critical care. Objective: To compare nursing workload, staffing and absenteeism in care among patients admitted to critical care units in the pre-pandemic period and during the pandemic. Methods: A retrospective cross-sectional study based on secondary data collected from February 24, 2019 to February 24, 2021. Results: Three articles are presented: (1) Nursing workload in the pandemic by COVID-19: a scoping review. 1,120 studies were identified and eight were included. The severity of COVID-19 patients impacted institutions in the face of human resource crisis, there was an increase in nursing workload. (2) Comparison of workload by Nursing Activities Score and nursing scaling before and during the COVID-19 pandemic in critical care units. A significant increase in NAS by 4.2 points was identified in the pandemic period; (3) Impact of the COVID-19 pandemic on absenteeism of intensive care nursing staff. An increase in the average number of absences among nursing staff was identified. Infectious and parasitic diseases were prevalent (23%) in the reasons for absence in the pandemic period, occurring five times more compared to the pre-pandemic period. COVID-19 infection was the leading cause of absences (13.4%) in the pandemic period. Implications for clinical practice: It was possible to analyze the management and care impacts of the pandemic by COVID-19 in critical care units, which had to be adapted to serve the population by reorganizing the structure of critical care units, expanding the number of beds, hiring and adjusting nursing staff. Final considerations: The score measured by NAS showed an increase and statistical difference between the pre-pandemic and pandemic periods. Regarding the staff dimensioning, it was necessary to hire and reallocate the team to meet the demands in critical units, following the current norms. The absenteeism-sickness in the pandemic period showed a significant increase and a high rate of contamination by COVID-19 among professionals, as well as an increase in unjustified absences of the team. The findings of this study contribute to nursing by allowing an understanding of the magnitude of scores used in care practice and their implication on people management and, consequently, better working conditions.
Introduction: The measurement of nursing workload enables the identification of patients' care needs and may influence the dimensioning of the nursing team and allocation of human resources, aiming at patient safety and satisfaction. There is evidence of increased nursing workload in patients diagnosed with COVID-19 in critical care. Objective: To compare nursing workload, staffing and absenteeism in care among patients admitted to critical care units in the pre-pandemic period and during the pandemic. Methods: A retrospective cross-sectional study based on secondary data collected from February 24, 2019 to February 24, 2021. Results: Three articles are presented: (1) Nursing workload in the pandemic by COVID-19: a scoping review. 1,120 studies were identified and eight were included. The severity of COVID-19 patients impacted institutions in the face of human resource crisis, there was an increase in nursing workload. (2) Comparison of workload by Nursing Activities Score and nursing scaling before and during the COVID-19 pandemic in critical care units. A significant increase in NAS by 4.2 points was identified in the pandemic period; (3) Impact of the COVID-19 pandemic on absenteeism of intensive care nursing staff. An increase in the average number of absences among nursing staff was identified. Infectious and parasitic diseases were prevalent (23%) in the reasons for absence in the pandemic period, occurring five times more compared to the pre-pandemic period. COVID-19 infection was the leading cause of absences (13.4%) in the pandemic period. Implications for clinical practice: It was possible to analyze the management and care impacts of the pandemic by COVID-19 in critical care units, which had to be adapted to serve the population by reorganizing the structure of critical care units, expanding the number of beds, hiring and adjusting nursing staff. Final considerations: The score measured by NAS showed an increase and statistical difference between the pre-pandemic and pandemic periods. Regarding the staff dimensioning, it was necessary to hire and reallocate the team to meet the demands in critical units, following the current norms. The absenteeism-sickness in the pandemic period showed a significant increase and a high rate of contamination by COVID-19 among professionals, as well as an increase in unjustified absences of the team. The findings of this study contribute to nursing by allowing an understanding of the magnitude of scores used in care practice and their implication on people management and, consequently, better working conditions.
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Palavras-chave
Enfermagem, Carga de trabalho, Unidade de terapia intensiva, Cuidados críticos, COVID-19, Nursing, Workload