NICU nurses' perception of daily job challenges affects patient care, study finds

A neonatal intensive care unit nurse's ability to provide high quality care is affected by perceived workload, a factor that goes beyond how many patients are cared for, a study published in JAMA Pediatrics found.

The study authors collected data from 332 shifts of 12 hours of 136 NICU nurses. During each shift, the researchers gathered measures of infant-to-nurse staffing ratios.

The NICU nurses completed a questionnaire that measured their perceived workload based on mental demand, physical demand, how hurried they felt during a shift and overall effort needed to accomplish patient care.

The nurses also gave the researchers reports on tasks deemed "essential care" that they missed during shifts.

The nurses' perceived workloads consistently had a significant influence on missed essential care, including activities like oral feedings, lab result collection and equipment safety checks.

The study found a nurse's perception of workday difficulty — from being squeezed for time to the mental stresses of the shift — affected ability to provide the best care possible, regardless of the infant-to-nurse staffing ratio.

"We were surprised to discover how important subjective workload is to care quality, and it's something we typically don't measure in healthcare," said lead researcher Heather Tubbs Cooley, PhD, RN, of The Ohio State University in Columbus. "This is really the nurse's voice telling us how intense things were."

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