Workload In Intensive Care Unit Research Articles

Reimagine the ICU: Healthcare Professionals' Perspectives on How Environments (Can) Promote Patient Well-Being.

This study aims (1) to understand the needs and challenges of the current intensive care unit (ICU) environments in supporting patient well-being from the perspective of healthcare professionals (HCPs) and (2) to explore the new potential of ICU environments enabled by technology. Evidence-based design has yielded how the design of environments can advocate for patient well-being, and digital technology offers new possibilities for indoor environments. However, the role of technology in facilitating ICU patient well-being has been unexplored. This study was conducted in two phases. First, a mixed-method study was conducted with ICU HCPs from four Dutch hospitals. The study investigated the current environmental support for care activities, as well as the factors that positively and negatively contribute to patient experience. Next, a co-creation session was held involving HCPs and health technology experts to explore opportunities for technology to support ICU patient well-being. The mixed-method study revealed nine negative and eight positive patient experience factors. HCPs perceived patient emotional care as most challenging due to the ICU workload and a lack of environmental support in fulfilling patient emotional needs. The co-creation session yielded nine technology-enabled solutions to address identified challenges. Finally, drawing from insights from both studies, four strategies were introduced that guide toward creating technology to provide holistic and personalized care for patients. Patient experience factors are intertwined, necessitating a multifactorial approach to support patient well-being. Viewing the ICU environment as a holistic unit, our findings provide guidance on creating healing environments using technology.

Info-NAS: A Computer Program for the Calculation of Intensive Care Unit Nurse Workload.

The purpose of this study was to design an algorithm that allows automatic calculation of nursing workload in intensive care units, based on the Nursing Activities Score scale, through a computer program. Three methodological steps were used: (1) Delphi method (group of experts); (2) identification of the correspondence: Nursing Activities Score items-variables in the EHR, namely, standardized terminology, laboratory values, and prescriptions; and (3) weighting of variables independently by a group of experts. Finally, the algorithm of the computer program was tested. The results showed an algorithm that calculates the nursing workload in an ICU. The calculation is objective and automatic through the EHRs. This study shows the feasibility of the algorithm as a rapid and objective strategy to quantify adequate nurse staffing in intensive care units. Moreover, it provides nurses with a practical resource for the correct completion of records and is thus an incentive to maintain or improve their quality.

Determinants of Professional Fulfillment and Burnout Among Intensivists: A National Survey by the Society of Critical Care Anesthesiologists in 2022.

Increased burnout and decreased professional fulfillment among intensive care physicians is partly due to intensive care unit (ICU) workload. Although the SARS-CoV-2 (COVID-19) pandemic increased ICU workload, it also may have increased feelings of personal fulfillment due to positive public perceptions of physicians caring for COVID patients. We surveyed critical care anesthesiologists to identify the effect of provider demographics, ICU workload, and COVID-19-related workload, on professional fulfillment and burnout. We performed an exploratory survey of 606 members of the Society of Critical Care Anesthesiologists (SOCCA) in January and February 2022. We used the Stanford Professional Fulfillment Index (PFI) to grade levels of professional fulfillment and markers of burnout (ie, work exhaustion and disengagement). Univariable and multivariable models were used to identify associations between provider demographics and practice characteristics and professional fulfillment and work exhaustion. One hundred and seventy-five intensivists (29%) responded. A total of 65% were male and 49% were between 36 and 45 years old. The overall median PFI score-0 (none) to 24 (most professional fulfillment)-was 17 (IQR, 1-24), with a wide distribution of responses. In multivariable analysis, factors associated with higher professional fulfillment included age >45 years ( P =.004), ≤15 weeks full-time ICU coverage in 2020 ( P =.02), role as medical director ( P =.01), and nighttime home call with supervision of in-house ICU fellows ( P =.01). Professional fulfillment and work exhaustion in this cross-sectional survey were associated with several demographic and practice characteristics but not COVID-19-related workload, suggesting that COVID-19 workload may not have either positive or negative perceptions on professional fulfillment.

Avatar-based patient monitoring improves information transfer, diagnostic confidence and reduces perceived workload in intensive care units: computer-based, multicentre comparison study

Patient monitoring is the foundation of intensive care medicine. High workload and information overload can impair situation awareness of staff, thus leading to loss of important information about patients’ conditions. To facilitate mental processing of patient monitoring data, we developed the Visual-Patient-avatar Intensive Care Unit (ICU), a virtual patient model animated from vital signs and patient installation data. It incorporates user-centred design principles to foster situation awareness. This study investigated the avatar’s effects on information transfer measured by performance, diagnostic confidence and perceived workload. This computer-based study compared Visual-Patient-avatar ICU and conventional monitor modality for the first time. We recruited 25 nurses and 25 physicians from five centres. The participants completed an equal number of scenarios in both modalities. Information transfer, as the primary outcome, was defined as correctly assessing vital signs and installations. Secondary outcomes included diagnostic confidence and perceived workload. For analysis, we used mixed models and matched odds ratios. Comparing 250 within-subject cases revealed that Visual-Patient-avatar ICU led to a higher rate of correctly assessed vital signs and installations [rate ratio (RR) 1.25; 95% CI 1.19–1.31; P < 0.001], strengthened diagnostic confidence [odds ratio (OR) 3.32; 95% CI 2.15–5.11, P < 0.001] and lowered perceived workload (coefficient − 7.62; 95% CI − 9.17 to − 6.07; P < 0.001) than conventional modality. Using Visual-Patient-avatar ICU, participants retrieved more information with higher diagnostic confidence and lower perceived workload compared to the current industry standard monitor.

Assessment of the nursing workload in intensive care units following cardiac surgery using the nursing activities score in relation to regulations in Serbia

Introduction. The Nursing Activities Score is used to quantify, assess, and identify the workload of nurses in intensive care units, and is widely considered a very effective, simple, standardized measurement scale, sufficiently detailed to be implemented in everyday hospital practice. The aim of the study is to evaluate the workload of nurses using the results of the Nursing Activities Score and compare the nurse-to-patient ratio with regulations in our country. Material and Methods. The study included 131 patients who underwent cardiac surgery in the period from November 1 to November 30, 2021. Surgical data and corresponding Nursing Activities Score values were obtained from hospital information system. In the intensive care unit, nursing activities were monitored and scored daily. Results. Using the Nursing Activities Score, 344 measurements were recorded in the study sample. The mean Nursing Activity Score was 88.27 ? 3.63, and the highest was 102.97 ? 1.89 on the first postoperative day. The nurse-to-patient ratio was 1.03:1 on the first postoperative day, and about 0.8:1 on the second and third postoperative days. There was a statistically significant difference in the mean Nursing Activities Score between postoperative days (p &lt; 0.0005) between the first and second day (102.96 vs. 79.46) and the first and third day (103.46 vs. 83.58). Conclusion. On the first postoperative day, the optimal number of nurses according to the Nursing Activities Score is higher compared to the State Regulations, while for the rest of the days in the intensive care unit the nurse-to-patient ratio corresponds to the regulations.

Work Experience of Surgical Technologists Under the COVID-19 Disaster: A Qualitative Study

Background: Due to the crisis of shortage of specialized nurses and high workload in intensive care units and emergency departments of hospitals during the COVID-19 pandemic, hospital managers had to use nurses and staff in other departments as reinforcements despite their lack of necessary competency to work in those departments. Hence, this study investigated surgical technologists' work experiences during the COVID-19 disaster. Methods: This qualitative study was conducted using the conventional content analysis method at Alborz University of Medical Sciences. The participants were 42 surgical technologists selected using purposive sampling from 14 hospitals in 10 cities of Iran. Data were collected through semi-structured interviews and analyzed in MaxQDA2 software using the content analysis method. Results: The results of this study were classified into two main categories, "challenges" and "coping strategies. The first main category consists of three subcategories, "psychological-emotional stress," "managerial crises," and "physical injuries." The second main category also includes three subcategories, "emotion-based strategy," "cognition-based strategy," and "problem-based strategy." Conclusions: The surgical technologists' experience indicated that the COVID-19 crisis posed serious challenges, mostly related to the shortage of protective facilities and the lack of adequate training about self-care and patients in wards with no work experience. Therefore, managers of hospitals should offer appropriate purposive training courses to sufficiently develop their staff's knowledge and competence to manage the crisis in pandemics or epidemics.

A Stacked Generalization Chest-X-Ray-Based Framework for Mispositioned Medical Tubes and Catheters Detection

Tubes and catheters are medical devices introduced into the human body to help ill patients in critical health conditions. However, several positioning errors occur during or after the placement of such devices (Endotracheal tubes mispositioned in 10 to 20% of intubations). In addition, the delay of X-ray diagnosis after surgery can cause serious complications. Such delays are caused by the hospitals' resourcelessness or due to workload in intensive care units. The X-rays images availability (Most used diagnosis modality in intensive care units, 40% to 50%) and the presence of tubes in those images (lines are present on 33% of X-ray images) present a fertile ground to feed DCNNs training on tube error detection tasks and reduce complications. However, training and tuning one DCNN learner to resolve tube detection is time-consuming. Therefore, we propose a custom stacked generalization framework to combine wake learners with a proposed meta learner neural network architecture to resolve tube error detection tasks. The proposed framework AUC (93.84%) outperforms other related work methods with the input size of (380pixel*380pixel). Furthermore, we demonstrated the sensibility of stacked generalization to the number of base learners. Moreover, we validated the utility of input cross-validation used to form level1-metadata for the stacked generalization. Our framework can be adapted to be integrated with a CAD (computer aid decision system) for tubes error detection. The CAD can detect errors immediately after patient screening and notify radiologists to prioritize diagnosis of cases with positioning errors to adjust tubes and reduce risks significantly.

Management of patient tubes and lines during early mobility in the intensive care unit

ObjectiveThe purpose of this study was to better understand the impact of patient tubes/lines on early mobility therapy sessions for patients in the intensive care unit (ICU). BackgroundEarly mobility improves patient outcomes in the ICU, but its use is suboptimal. Significant barriers to early mobility include the risk of dislodging patient tubes/lines, nursing workload, and staffing constraints. MethodSecondary statistical analyses were conducted on an existing quality improvement dataset collected during the observation of 22 early mobility therapy sessions in four ICUs at two hospitals using descriptive statistics, Pearson's correlation coefficient, and Spearman rho's calculations. ResultsPatients had an average of 8.6 tubes/lines. During each early mobility session, staff spent an average of 12.4 minutes, or 61.4% of the total duration of time, focused on the management of patient tubes/lines. Significant positive correlations were found between; 1) the number of patient tubes/lines and the amount of time needed by staff to organize and manage them during early mobility activities (r = 0.517, p = 0.014), and 2) the number of patient tubes/lines and the number of staff required to assist during early mobility activities (r = 0.630, p = 0.002). ConclusionPatient tube/line management has significant implications on ICU staff time and workload during early mobility. Additional research is needed to better understand how nurses and other frontline staff manage patient tubes/lines during mobilization in the ICU. ApplicationResearchers, healthcare providers, and engineers should identify tube/line management strategies to reduce workload and staffing barriers to early mobility in the ICU.

Nurses’ perceptions on the effects of high nursing workload on patient care in an intensive care unit of a referral hospital in Malawi: a qualitative study

BackgroundThe Malawi health system has taken numerous actions to reduce high nurse workloads, despite this, shortage of nurses especially in critical care settings still persists due to lack of prioritisation of critical care. Therefore, it is important to understand the effects of high nursing workload in Intensive Care Unit (ICU). This study aimed at exploring the perceptions of nurses regarding the effects of high nursing workload on patient care in ICU at Queen Elizabeth Central Hospital.MethodsThis qualitative descriptive study was conducted in a general ICU at Queen Elizabeth Central Hospital in Blantyre, Malawi. A purposive sample of 12 nurses working in the ICU was selected. Participants included full-time nurses working in the ICU. A total of 10 In-depth interviews were conducted to collect data upon which data saturation was reached. A semi-structured interview guide was used for data collection. Data was analysed manually using thematic analysis method by Braun & Clarke.ResultsStudy findings indicated that high nursing workload compromises the delivery of quality nursing care to critically ill patients, compromises patient safety and has negative impact on nurses’ wellbeing.ConclusionThe study findings portray that nurses are aware of the negative effects that high nursing workload has on patient care. The study findings support the need for more ICU nurses in order to reduce nurse workloads and the need for nurse managers and policy makers to develop strategies to manage nurse workloads and its effects on patient care.

Do frail elderly people affect the nursing workload in intensive care units?

Compare the nursing workload according to the condition of frailty in elderly people in an intensive care unit (ICU). A cross-sectional study whose sample included patients aged ≥60 years who were hospitalized for ≥24 hours in the ICU of a university hospital in São Paulo, Brazil. The Tilburg Frailty Indicator (TFI) was used to identify frailty in elderly people and the Nursing Activities Score (NAS) was used to measure the nursing workload. In a sample of 204 elderly people, frailty was found in 156 (76.5%). The elderly people contributed to high nursing workload (mean NAS 75.9) on the first day in the ICU, but frailty did not significantly change the NAS (p = 0.606) (frail 75.7 versus non-frail 76.5), either based on the mean value or the proportion of patients in each category. The condition of frailty in elderly people did not increase the nursing workload in the ICU.

Stress as a Workload in Intensive Care Units

Stress is one of the significant workloads in intensive care units. This survey examines the relationship between the level of stress experienced, gender, age, length of practice and the degree of the workplace. It maps the factors that lead to the emergence of stress in intensive care units and examines its impact on work performance. Results from 121 respondents working in intensive care units show that the level of stress correlates with age and is typical for certain stages of life. Work stress is mostly created by load, where the physical and mental component is applied. Total physical activity corresponded to moderate load and the most important physical factors represented increased demands on the musculoskeletal system and disturbance of sleep rhythm. The level of mental stress was also in the moderate values. The most important psychologicalstressors were identified as a high degree of responsibility and increased demands on cognitive functions

Nursing physical workload and mental workload in intensive care units: Are they related?

AimIn order to ensure patient safety and quality of care, it is important to consider factors which may impact on nursing workloads. This study aimed to investigate the simultaneous physical and mental workload and any relationships between these concepts on nurses working in intensive care units.DesignA cross‐sectional design was undertaken.MethodParticipants were nurses (N = 105) recruited from six adult intensive care units which met the inclusion criteria. Nursing Activities Score (NAS) to measure physical workload and NASA Task Load Index (NASA‐TLX) to measure mental workload were used. Data were collected for each participating nurse in three shifts (morning, evening and night). Data were analysed using bivariate correlation and multivariable linear regression analysis.ResultsThe mean (SD) of nurses' physical and mental workload was 72.84% (22.07%) and 70.21 (12.36), respectively. A significant relationship between physical and mental workload (p <.001) was identified.

Effect of Nursing Workload in Intensive Care Units.

Nursing work efforts are important in providing sound healthcare services, especially in the intensive care units (ICU). Complications and adverse events are more liable to occur among patients in the ICU and these patients require more attention and nursing care. Most of the research in this field is mainly focused on the effect of staffing and its correlation to patient safety and satisfaction. Previous studies also showed that reduced nursing staffing was significantly associated with the development of pneumonia in ICU patients who needed more nursing requirements. An increase in nursing workload is also significantly associated with an increased incidence rate of nosocomial infections. The association between nursing workload in ICU patients and increased incidence rates of mortality is also supported by previous studies. The nurse-to-patient ratio has been previously used to evaluate patient safety correlation with the nursing workload as reported by previous reports. However, previous research shows that the nursing workload is a more complex correlation and can not be determined by a simple ratio as the nurse-to-patient one. Evidence shows that many adverse events may occur with patients in the ICU secondary to reduced nursing care such as increased mortality, length of hospital stay, and catching in-hospital infections. In the current study, we aim to review the outcomes from previous investigations to further emphasize the effect of nursing workload on ICU patient outcomes and safety.

Factors associated with nursing workload in three intensive care units.

To determine the nursing workload in intensive care units (ICUs) and the factors associated with the Nursing Activities Score (NAS). An analytical cross-sectional study was carried out in three ICUs in Bucaramanga, Colombia, between February 2018 and February 2020. The nursing workload was estimated based on the NAS. A descriptive and bivariate analysis stratified by ICU was performed using a robust multiple linear regression model, and the factors associated with the nursing workload (p < 0.05) were estimated. In this study, 362 records were included. The median NAS was 68.1 points (Q1:47.2-Q3:116.7). APACHE II (β = 3.13, CI: 95% 2.28; 3.98), days of stay in ICU ≥3 (β = 16.78, CI: 95% 6.15; 27.41), surgery provenance service (β = 22.31, CI: 95% 9.76; 34.86), and traumatology and emergencies diagnostic category (β = 33.72, CI 95%: 9.90; 57.53) were associated with high NAS scores. The nursing staff spend approximately 70% of their time on a single patient, and administrative work takes up most of their time. Hospital stays of longer than 3 days, high APACHE II score, coming from the surgery department, and having a diagnosis of trauma and emergency were associated with a high workload.

The objective nursing workload and perceived nursing workload in Intensive Care Units: Analysis of association

BackgroundA range of classification systems are in use for the measurement of nursing workload in Intensive Care Units. However, it is unknown to what extent the measured (objective) nursing workload, usually in terms of the amount of nursing activities, is related to the workload actually experienced (perceived) by nurses. ObjectivesThe aim of this study was to assess the association between the objective nursing workload and the perceived nursing workload and to identify other factors associated with the perceived nursing workload. MethodsWe measured the objective nursing workload with the Nursing Activities Score and the perceived nursing workload with the NASA-Task Load Index during 228 shifts in eight different Intensive Care Units. We used linear mixed-effect regression models to analyze the association between the objective and perceived nursing workload. Furthermore, we investigated the association of patient characteristics (severity of illness, comorbidities, age, body mass index, and planned or unplanned admission), education level of the nurse, and contextual factors (numbers of patients per nurse, the type of shift (day, evening, night) and day of admission or discharge) with perceived nursing workload. We adjusted for confounders. ResultsWe did not find a significant association between the observed workload per nurse and perceived nursing workload (p=0.06). The APACHE-IV Acute Physiology Score of a patient was significantly associated with the perceived nursing workload, also after adjustment for confounders (p=0.02). None of the other patient characteristics was significantly associated with perceived nursing workload. Being a certified nurse or a student nurse was the only nursing or contextual factor significantly associated with the perceived nursing workload, also after adjustment for confounders (p=0.03). ConclusionWorkload is perceived differently by nurses compared to the objectively measured workload by the Nursing Activities Score. Both the severity of illness of the patient and being a student nurse are factors that increase the perceived nursing workload. To keep the workload of nurses in balance, planning nursing capacity should be based on the Nursing Activities Score, on the severity of patient illness and the graduation level of the nurse.

Nursing workload in intensive care units and the influence of patient and nurse characteristics.

Understanding factors that can potentially influence patient care and nursing workload in intensive care units is important. Previous studies have shown contradictory outcomes about the relationships between nursing workload and patient and nurse characteristics. This study aimed to investigate nursing workload in intensive care units and examine the association between this in relation to patient and nurse characteristics. A cross-sectional design was conducted. All nurses who were working in the intensive care units of five hospitals and met the study criteria were enrolled in the study. Two demographic questionnaires collected nurse and patient demographic information. The Nursing Activities Score was applied to determine nursing workload in three shifts (morning, evening, night) for each nurse. Data were analysed using the independent sample t-test, one-way analysis of variance, and multivariable linear regression analysis. The Nursing Activities Score was calculated for 509 patients who were under the care of 105 intensive care unit nurses. The mean (SD) Nursing Activities Score was 72.84% (22.07%). Morning shifts, male patients, medical treatments, and referred patients from the emergency ward and other intensive care units imposed a higher workload for nurses. Specifically, female nurses, increased number of patients receiving care, and increased patient length of intensive care unit stay were directly associated with increased Nursing Activities Scores. Work in surgical and burn intensive care units were inversely associated with the Nursing Activities Score. This study suggests that the workload of nurses in intensive care units can be affected by both nurse and patient characteristics. The findings can be used to ensure appropriate staffing of intensive care units by nurses. However, nurse and patient characteristics should not be considered the only factors that influence nursing workload in intensive care units.

Assessment of Nurses’ Workload in Intensive Care Unit by Use of Scoring Systems

Aim. To assess the level of correlation between two scoring systems: patient categorization according to the Croatian Nursing Council consensus and Nine Equivalents of Nursing Manpower Use Score (NEMS) and their ability to determine if the number of nurses working in the intensive care unit (ICU) is optimal to provide adequate nursing care, and to assess the level of correlation between the severity of patients’ illness and the level of nurses’ satisfaction with provided care. Methods. Research was performed in surgical ICU of the Clinical Department of Anesthesiology, Resuscitation and Intensive Care Medicine, University Hospital Dubrava, in the period between January 8th and April 14th, 2014. 256 patients aged 18-92 years were included in the study. Patient categorization and NEMS were calculated each day during the first 7 days of the ICU stay. NEMS was calculated using a pre-made table of variables and categorization was calculated using an electronic form included in nursing electronic patient files. Satisfaction of provided care was expressed using the Likert scale (1-5). Results. Study results have shown a moderate but significant level of correlation between the categorization and NEMS scores. Mean NEMS score during the first 7 days in the ICU was 26.93 ± 4.64 and the highest measured values were at day 4 (30.34±8.1) after which they started decreasing. Mean cumulative NEMS throughout the whole ICU stay was 269.3. According to the fact that according to NEMS scoring system one nurse can provide maximum of 45 points for 24 hours, the results have shown that a 10 bed ICU needs at least 5.98 (6) nurses to provide adequate level of care. Average categorization score was 57.83±4.29 and the highest recorded score was at day 7 (59.7±4.44). According to the categorization scoring system time needed to provide care for one 4th category patient throughout 24 hours is 10 or more hours. Since the description of the 4th category doesn’t specify what is the upper limit of time needed to provide care for each patient, 14 hours was used to determine a minimum number of nurses, and according to the categorization score 5.83 (6) nurses are needed in the ICU. Nurses’ satisfaction with provided care has shown a significant negative correlation with NEMS score and categorization score. Conclusion. Both scoring systems can be used to assess nursing workload in a surgical ICU. However, NEMS is simpler and quicker to use, more applicable, useful and should be routinely used in place of categorization to assess nursing workload in surgical ICUs.

Omission of nursing care, professional practice environment and workload in intensive care units.

The present study aimed to characterize the omission of nursing care according to the nurses' perception, the professional practice environment and the nursing workload of intensive care units (ICU) in Brazil. Additionally, the influence of the practice environment and nursing workload on such omission was assessed, as well as the type of care omitted regarding priority classification. In order to ensure patient safety and quality of care, it is necessary to invest in improvements in nursing care practices. The present cross-sectional study was performed in three large ICU in Brazil. The omission of nursing care was identified using the MISSCARE-BRASIL instrument, and the environment and duration of professional nursing practice were analysed using the Practice Environment Scale (PES) and Nursing Activities Score (NAS), respectively. "Ambulation three times a day or as prescribed" was the form of care reported as the most omitted in the three studied units. The reasons for not performing care included the following: inadequate number of staff, inadequate physical blueprint of the unit/sector and the professional having more than one employment relationship. Upon characterizing the work environment in the ICU according to the PES, ICU 1 and 3 were considered "mixed" environments, whereas ICU 2 was considered a "favourable" environment. The professional practice environment, as well as the workload, may constitute predictive factors for the omission of care. The nursing workload and practice environment influence the omission of care. Moreover, the establishment of criteria for the prioritization of care when faced with adverse work conditions is necessary.

Carga laboral de los profesionales de enfermería en unidad de cuidados intensivos. Estudio descriptivo: «CARETIME»

IntroductionNursing workload in intensive care units is directly related to the efficiency and quality of care. However, there is limited data on this subject in Colombia, despite the importance of the administration and management of these units. ObjectiveTo describe the workload of nurses in a high complexity ICU in Santander, Colombia. MethodologyA descriptive study was carried out with the professional nursing staff of an ICU of a high complexity hospital between July and November 2018. Nursing Activities Score (NAS) was used to measure the workload. The information was entered into the software EpiData 3.1, and then exported to the statistical package Stata 14.0 where it was analysed using descriptive statistics. ResultsThe most prevalent type of diagnosis was in the infectious category, with 24.0% (n=12). The mean stay in ICU stay was 11 days (Q1:7- Q3:17) and the degree of criticality was calculated with the Sequential Organ Failure Assessment (SOFA) score for each patient, obtaining a mean of 8.1±3.44 points. The mean overall NAS score was 60.51±12.13 (min: 36.6 and max: 92.7). The activity in which nurses spent the most time in the ICU is monitoring and control, with 16.18±4.34 according NAS categories, including mobilisation and positional changes with 9.69±3.97, followed by renal support with 8.71±3.30. ConclusionThe ICU nursing staff use more than half of their shift time to a single patient in the intensive care unit (61). Similarly, direct care activities occupy the largest percentage of their time during this period.

Hubungan Beban Kerja Dengan Tingkat Stres Perawat Ruang Intensive Care Unit dan Instalasi Gawat Darurat

The workload in the room is not always a cause of stress on nurses, the workload will be a source of stress if the number of workloads is not proportional to the ability of both the physical or expertise and the time available to nurses. Besides, nurses are faced with patients who trigger an increasing stress on nurses. This research was conducted at Siaga Medika General Hospital in Pemalang. The research design used quantitative associative analytic through cross-sectional approach. The sample of this study was 45 nurses who served in the Intensive Care Unit and Emergency Departments because the nurses' stress levels were higher than the nurses’ stress levels in the other treatment rooms (ward) obtained through total sampling because the population was less than 100, so that all population used as research samples. The Work Stress research instrument used the standard Depression Anxiety Stress Scale questionnaire, while the workload questionnaire adopted the previous research and was modified. The results showed that there was a correlation between workload and stress level of Intensive Care Unit nurses and stress of Emergency Departments nurses. This showed that nurses who have a heavy workload that is not comparable to the duties of nurses with the average number of patients, the number of types of work that must be done. If this is not managed properly, it will cause increased stress.H This is what becomes the workload of Intensive Care Unit and Emergency Departments nurses in Siaga Medika General Hospital in Pemalang which can cause an increase of stress.