Assessment of Nursing Workload and Adverse Events Reporting among Critical Care Nurses in the United Arab Emirates

Abstract

Background: Nursing is a demanding job, and excessive workloads have been demonstrated to negatively impact patient care. This study aimed to determine the associations between nursing workload on the days of intensive care unit (ICU) admission and discharge and adverse events among patients (i.e. ICU readmission and medication errors). Methods: This study used a retrospective cohort design. We reviewed medical records for 270 patients admitted to the ICU from three hospitals in the United Arab Emirates between February and April 2023. Collected data included patients’ demographics, diagnosis, acuity score on ICU admission/discharge days, Nursing Activities Score (NAS) on ICU admission/discharge days and adverse events reported (i.e. occurrence of medication errors and re-admission to ICU after discharge). Results: The nursing workload on ICU admission and discharge days was high (NAS=72.61 and NAS=52.61, respectively). There were significant associations between ICU readmission and nursing workload at ICU admission and discharge. Moreover, there was a significant relationship between the occurrence of medication errors and nursing workload on the day of ICU admission, with more medication errors occurring in patients with higher NAS scores. Conclusion: The complexity of nursing activities and the severity of patients’ conditions directly impact the nursing workload and patient outcomes. A practical strategy to reduce the nursing workload may be calculating the NAS to clarify the actual time spent by nurses to provide the required care based on the patient’s condition. Adoption of new technologies to enhance medication safety and minimise errors may be another strategy to reduce the impact of the high nursing workload in ICU settings.