Measuring workload of ICU nurses with a questionnaire survey: the NASA Task Load Index (TLX)

Abstract

High workload of nurses in Intensive Care Units (ICUs) has been identified as a major patient safety and worker stress problem. However, relatively little attention has been dedicated to the measurement of workload in healthcare. The objectives of this study are to describe and examine several methods to measure workload of ICU nurses. We then focus on the measurement of ICU nurses’ workload using a subjective rating instrument: the NASA TLX. We conducted secondary data analysis on data from two, multi-site, cross-sectional questionnaire studies to examine several instruments to measure ICU nurses’ workload. The combined database contains the data from 757 ICU nurses in eight hospitals and 21 ICUs. Results show that the different methods to measure workload of ICU nurses, such as patient-based and operator-based workload, are only moderately correlated, or not correlated at all. Results show further that among the operator-based instruments, the NASA TLX is the most reliable and valid questionnaire to measure workload and that NASA TLX can be used in a healthcare setting. Managers of hospitals and ICUs can benefit from the results of this research as it provides benchmark data on workload experienced by nurses in a variety of ICUs.