Work In Intensive Care Unit Research Articles

Evaluation of the mental health status of intensive care unit healthcare workers at the beginning of COVID-19 pandemic.

During pandemic periods, mental health issues are highly prevalent, particularly among healthcare workers who are at a higher risk of developing psychiatric disorders. The aim of this study is to evaluate the mental health status of the intensive care unit (ICU) healthcare workers, who play a vital role in managing the COVID-19 pandemic, in terms of the quality of sleep, levels of depressive and anxiety symptoms, stress and to determine the factors that affect their mental health. The research was conducted in April 2020 and incorporated a total of 79 participants working in an university hospital ICUs in Turkey. Pittsburgh Sleep Quality Index (PSQI), Depression Anxiety Stress Scale 42 (DASS-42), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were applied. Among the participants, 58 individuals comprising 73.4% of the cohort were working in the ICUs, managing patients infected with COVID-19. Those working in ICUs with COVID-19 patients had significantly higher DASS-S, BAI, and BDI scores. Doctors' BDI scores were significantly lower compared to both nurses and other healthcare workers. Participants exhibiting COVID-19 symptoms manifested significantly higher BAI scores in compared to those without such symptoms. Healthcare workers involved in ICUs with COVID-19 patients were more significantly affected psychologically, doctors had lower depressive symptoms as compared to other healthcare workers. In addition, individuals with COVID-19 symptoms demonstrated significantly higher levels of anxiety. The findings of our study emphasize the significance of providing psychological support to healthcare workers throughout pandemics.

Evaluation of Work-Related Factors Affecting the Frequency of Overweight and Obesity Among Healthcare Workers in Intensive Care Units in a Training and Research Hospital

Objective: This study aimed to determine the prevalence of overweight and obesity among healthcare workers (HCWs) in intensive care units (ICU) and to evaluate the affecting work-related factors. Method: The cross-sectional study was conducted between 01.09.2022 and 01.11.2022 in HCWs (working in the ICUs) in a training and research hospital. Personal information form, international physical activity questionnaire (IPAQ short) were used in the study, and their self-reported height and body weights were recorded. Results: According to the Body Mass Index of the participants, 29.0% (n=60) were overweight and 13.0% (n=27) were obese. There are differences between advanced age, male gender, marital status being married, presence of obesity in family history, smoking, exposure to stress and pressure at work, lack of physical activity, sitting down to work for more than 3.5 hours in a day, shift work duration of more than 9.5 days per month, eating fast food, not being educated about obesity and overweight. Conclusion: Protecting workers against risk factors associated with overweight and obesity will increase the level of workers’ health and the quality of service received from the workers. This situation will have a positive impact on public health, reducing health costs and reducing losses for both the workers and the country's economy.

Determinants of hand hygiene compliance among healthcare workers in intensive care units: a qualitative study

BackgroundPracticing hand hygiene is a cost-effective method to decrease the occurrence of Healthcare-Associated Infections (HAIs). However, despite their simplicity, adhering to hand hygiene methods among healthcare workers (HCWs) can be highly challenging. We aim to examine the factors influencing hand hygiene compliance as perceived by HCWs working in the intensive care units (ICUs) at several major hospitals in Riyadh, Saudi Arabia.MethodThis qualitative study was conducted by adopting a content analysis to examine the interviews of HCWs who are currently working in the ICUs of various major hospitals located in the capital city of Riyadh, Saudi Arabia.ResultsWe interviewed 49 HCWs working in ICUs, with an average age of 38 and 8 years of experience. The HCWs comprised doctors (n = 12), anesthesiologists (n = 6), and nurses (n = 31). There were 34 females and 15 males among the participants. Our analysis revealed several factors that impact hand hygiene compliance, including individual, work/environment, team, task, patient, organizational, and management concerns. Several obstacles and possibilities for enhancement have been identified.ConclusionThe results of this study would enhance our comprehension of hand hygiene practices and serve as a foundation for creating future strategies and assessment methods to enhance compliance with hand hygiene protocols in ICUs.

Routes of SARS-Cov2 transmission in the intensive care unit: A multicentric prospective study

BackgroundThe risk of SARS-CoV-2 transmission to health care workers in intensive care units (ICU) and the contribution of airborne and fomites to SARS-CoV-2 transmission remain unclear. To assess the rate of air and surface contamination and identify risk factors associated with this contamination in patients admitted to the ICU for acute respiratory failure due to SARS-CoV-2 pneumonia. MethodsProspective multicentric non-interventional study conducted from June 2020 to November 2020 in 3 French ICUs. For each enrolled patient, 3 predefined surfaces were swabbed, 2 air samples at 1 m and 3 m from the patient’s mouth and face masks of 3 health care workers (HCW) were collected within the first 48 h of SARS-CoV-2 positive PCR in a respiratory sample. Droplet digital PCR and quantitative PCR were performed on different samples, respectively. ResultsAmong 150 included patients, 5 (3.6%, 95%CI: 1.2% to 8.2%) had positive ddPCR on air samples at 1 m or 3 m. Seventy-one patients (53.3%, CI95%: 44.5% to 62.0%) had at least one surface positive. Face masks worn by HCW were positive in 6 patients (4.4%, CI: 1.6% to 9.4%). The threshold of RT-qPCR of the respiratory sample performed at inclusion (odds ratio, OR= 0.88, 95%CI: 0.83 to 0.93, p < 0.0001) and the presence of diarrhea (OR= 3.28, 95%CI: 1.09 to 9.88, p = 0.037) were significantly associated with the number of contaminated surfaces. ConclusionIn this study, including patients admitted to the ICU for acute respiratory failure " contact route " of transmission, i.e. through fomites, seems dominant. While presence of SARS-CoV-2 in the air is rare in this specific population, the presence of diarrhea is associated to surface contamination around Covid patients.

Workplace violence against physicians in intensive care units in Turkey: A cross-sectional study.

Background Although there are many studies on violence against physicians in the literature, there are few studies on violence against physicians working in intensive care units (ICUs). We aimed to investigate the frequency, type and underlying factors of violence against physicians working in ICUs in Turkey in the past 1 year. Methods We collected data by sending a questionnaire about violence against physicians working in ICUs via e-mail and WhatsApp between 1 and 15 May 2022. IBM SPSS Statistics V.24.0 was used for data analysis. The chi-square test and Fisher precision test were used to compare categorical data. Results Over one-third (38.6%) of the 354 physicians participating in our study reported that they had been exposed to violence in the past year, while 20.7% reported that they had been exposed to violence more than once in the past year. There was a significant relationship between the frequency of exposure to violence, female gender, age group, title, subspecialization status, working style and duration of working in the ICU (p<0.05). There was no relationship between the working area, type of hospital and ICU and exposure to violence (p>0.05). The presence of restriction and control points at the entrance to ICUs prevented violence (p<0.05). Conclusion Physicians working in ICUs encounter violence against them. The frequency of violence increased after the Covid-19 pandemic. A significant relationship was found between the frequency of violence and female gender, age group, title, subspecialization status, working style and duration of working in ICUs.

Assessment of Levels of Occupational Stress among the Intensive Care Workers in a Selected Hospital in Lagos State

Background: Working in an Intensive Care Unit (ICU) comes with a great deal of physical, emotional, and psychological strain that can get worse with time if not properly managed. Numerous factors contribute to the extreme levels of stress experienced by healthcare professionals, such as long and demanding work hours, the burden of paperwork and legal matters, the disruption of work-life balance, the complexity of shared decision-making, and the high expectations placed ICU workers by on both patients and carers. Some outcomes of occupational stress among intensive care workers include bad safety culture, poor standard of care for patients and depression. Research Objective: The Purpose of the study was to ascertain the levels of occupational stress among the intensive care workers of a hospital. Methodology: The research was a cross-sectional descriptive study conducted in Lagos State University Teaching Hospital (LASUTH). An aggregate of 108 intensive care workers were sampled for the study. A pre-tested, semi-structured self-administered questionnaire was used to gather the data, and the statistical package for social sciences, SPSS version, was used for analysis. The means and standard deviations, or the median and interquartile range, were used to express continuous variables. The expressions for categorical variables were frequencies accompanied by percentages. The study employed chi square statistics to evaluate the correlation between categorical variables. Results: There is an average prevalence of stress among intensive care workers of LASUTH. Recommendation: Staff sshould undergo training on stress handling, in order to be able to manage their individual stressors and reduce the overall stress.

The effect of mask usage of the health personnel on blood gas analysis and cognitive strengthening during COVID-19 pandemic.

To investigate the effect of lengthy mask use on blood gas values and cognitive functions. The cross-sectional study was conducted in February and March 2022 at Mersin City Training and Research Hospital, Mersin, Turkey, and comprised healthcare professionals of either gender aged 20-60 years working in the 3rd level intensive care unit. Each volunteer was subjected to venous blood gas analysis at the beginning and end of the 8-hour morning shift. Coronavirus disease-2019 status was noted, and further data related to cognitive functions was collected using a 7-item questionnaire. Data was analysed using SPSS 20. Of the 63 subjects, 43(68.3%) were women and 20(31.7%) were men. The overall mean age was 33.53±6.76 years. There were 42(66.7%) subjects using N95 mask; 27(64.3%) women and 15(35.7%) men with mean age 32.38±6.54 years. There were 21(33.3%) subjects wearing surgical masks; 16(76.2%) women and 5(23.8%) men with mean age 35.95±0.76 years. Intergroup comparisons were non-significant for all the markers (p>0.05). Within the N95 mask group, potential of hydrogen and lactate values were significantly different (p<0.05), while in the surgical mask group, potential of hydrogen and partial pressure of oxygen were significantly different (p<0.05). There were 28(66.7%) subjects in the N95 group who had been affected by coronavirus disease-2019 compared to 16(76.2%) in the surgical mask group (p>0.05). Subjects in the N95 mask group had significant impaired cognitive functions compared to the surgical mask group (p<0.05). Impairment in cognitive functions in intensive care unit workers using masks could be explained by the development of intermittent long-term moderate hypoxia.

Burnout Syndrome in Intensive Care Unit Workers in a City in Northeastern Brazil

Introduction: Studies point out that intensive care workers can suffer from chronic stress and dissatisfaction with their work, which can favor the development of Burnout Syndrome. Goal: To estimate the prevalence of Burnout Syndrome and describe the characteristics of Intensive Care Unit (ICU) workers. Methodology: A descriptive epidemiological study was carried out on a population of 177 ICU workers - 52 doctors, 65 nurses and 60 physiotherapists - in the city of Feira de Santana, Bahia. A self-administered survey assessed sociodemographic data, work characteristics, lifestyle habits and Burnout Syndrome using the Maslach Burnout Inventory (MBI). Results: The prevalence of Burnout Syndrome was 47.9%, 45.3% among doctors, 55.6% among nurses and 33.3% among physiotherapists. Emotional exhaustion was the dimension most affected in the three categories studied. Males predominated among doctors and females among nurses and physiotherapists. Almost half of the workers studied were young, aged 34 or under, with little time in the profession. The majority had a partner, but no children. In terms of work characteristics, all three categories had high weekly working hours, high weekly on-call hours and night shifts in the ICU. Most of the workers studied reported practicing physical activity, drinking alcohol and not smoking. Final Considerations: There was a high prevalence of Burnout Syndrome and a high workload among the categories studied. It is necessary to reflect on the measures that can be adopted to reduce the prevalence of Burnout Syndrome among Intensive Care Unit workers.

Moral distress and psychological status among healthcare workers in a newly established paediatric intensive care unit.

Healthcare workers in intensive care units often experience moral distress, depression, and stress-related symptoms. These conditions can lower staff retention and influence the quality of patient care. This study aimed to evaluate the prevalence of moral distress and psychological status among healthcare workers in a newly established paediatric intensive care unit (PICU) in Hong Kong. A cross-sectional questionnaire survey was conducted in the PICU of the Hong Kong Children's Hospital; healthcare workers (doctors, nurses and allied health professionals) were invited to participate. The Revised Moral Distress Scale (MDS-R) Paediatric Version and Depression Anxiety and Stress Scale-21 items were used to assess moral distress and psychological status, respectively. Demographic characteristics were examined in relation to moral distress, depression, anxiety, and stress scores to identify risk factors for poor psychological outcomes. Correlations of moral distress with depression, anxiety, and stress were examined. Forty-six healthcare workers completed the survey. The overall median MDS-R moral distress score was 71. Nurses had a significantly higher median moral distress score, compared with doctors and allied health professionals (102 vs 47 vs 20). Nurses also had the highest median anxiety and stress scores (11 and 20, respectively). Moral distress scores were correlated with depression (r=0.445; P=0.002) and anxiety scores (r=0.417; P<0.05). Healthcare workers intending to quit their jobs had significantly higher moral distress scores (P<0.05). Among PICU healthcare workers, nurses had the highest level of moral distress. Moral distress was associated with greater depression, anxiety, and intention to quit. Healthcare workers need support and a sustainable working environment to cope with moral distress.

Correlation Between the Social Network Structure and Well-Being of Health Care Workers in Intensive Care Units: Prospective Observational Study.

Effective communication strategies are becoming increasingly important in intensive care units (ICUs) where patients at high risk are treated. Distributed leadership promotes effective communication among health care professionals (HCPs). Moreover, beyond facilitating patient care, it may improve well-being among HCPs by fostering teamwork. However, the impact of distributed leadership on the communication structure and well-being of HCPs remains unclear. We performed a social network analysis (SNA) to assess the characteristics of each HCP in the network, identify the number of HCP connections, analyze 4 centralities that can measure an HCP's importance, and evaluate the impact of distributed leadership structure on the well-being and communication structure of the medical staff. Wearable sensors were used to obtain face-to-face interaction data from the ICU medical staff at Mie University Hospital, Japan. Participants wore a badge on the front of their clothing during working hours to measure the total frequency of face-to-face interactions. We collected data about the well-being of medical staff using the Center for Epidemiological Studies-Depression (CES-D) questionnaire and measured 4 centralities using SNA analysis. A CES-D questionnaire was administered during the study to measure the well-being of the HCPs. Overall, 247 ICU workers participated in this clinical study for 4 weeks yearly in February 2016, 2017, and 2018. The distributed leadership structure was established within the ICU in 2017 and 2018. We compared these results with those of the traditional leadership structure used in 2016. Most face-to-face interactions in the ICU were among nurses or between nurses and other professionals. In 2016, overall, 10 nurses could perform leadership tasks, which significantly increased to 24 in 2017 (P=.046) and 20 in 2018 (P=.046). Considering the increased number of nurses who could perform leadership duties and the collaboration created within the organization, SNA in 2018 showed that the betweenness (P=.001), degree (P<.001), and closeness (P<.001) centralities significantly increased compared with those in 2016. However, the eigenvector centrality significantly decreased in 2018 compared with that in 2016 (P=.01). The CES-D scores in 2018 also significantly decreased compared with those in 2016 (P=.01). The betweenness (r=0.269; P=.02), degree (r=0.262; P=.03), and eigenvector (r=0.261; P=.03) centralities and CES-D scores were positively correlated in 2016, whereas the closeness centrality and CES-D scores were negatively correlated (r=-0.318; P=.01). In 2018, the degree (r=-0.280; P=.01) and eigenvector (r=-0.284; P=.01) centralities were negatively correlated with CES-D scores. Face-to-face interactions of HCPs in the ICU were measured using wearable sensors, and nurses were found to be centrally located. However, the introduction of distributed leadership created collaboration and informal leadership in the organization, altering the social network structure of HCPs and increasing organizational well-being. University Hospital Medical Information Network (UMIN) UMIN000037046; https://center6.umin.ac.jp/cgi-open-bin/icdr_e/ctr_view.cgi?recptno=R000042211.

Burnout syndrome among medical nurse-technicians in intensive care units in cardiovascular surgery.

Healthcare workers in intensive care units work under specifically hard conditions compared to healthcare workers who work under regular clinical conditions. In this sense, the research aims at assessing the level of burnout symptomatology among nurse technicians working in intensive care units for cardiovascular surgery and to compare those burnout levels with those recorded for medical technicians working under regular clinical conditions. The research was designed as a cross-sectional study. The sample consisted of nurse technicians working in intensive care units specializing in cardiovascular surgery (70 participants) and nurse technicians working under regular clinical conditions (70 participants) at the Institute for Cardiovascular Diseases "Dedinje," Belgrade, Serbia. To evaluate the manifestation of burnout syndrome at work, the analysis uses the Serbian version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). To examine the variances in the average sub-scores for burnout within two groups of medical technicians, the study used Two Independent Samples T-test. The statistically noteworthy differentiation was ascertained for emotional exhaustion and personal accomplishment, but this does not hold true for depersonalization. However, the mean score values across the different burnout levels (low, moderate, high) are similar in two cohorts of respondents (p > 0.05). This study will serve as an impetus for a policy reform focused on ameliorating working conditions and improving healthcare workers' satisfaction and overall healthcare quality.

Becoming futile: the emotional pain of treating COVID-19 patients.

The COVID-19 pandemic has had a profoundly detrimental impact on the emotional wellbeing of health care workers. Numerous studies have shown that their rates of the various forms of work-related distress, which were already high before the pandemic, have worsened as the demands on health care workers intensified. Yet much less is known about the specific social processes that have generated these outcomes. This study adds to our collective knowledge by focusing on how one specific social process, the act of treating critically ill COVID-19 patients, contributed to emotional pain among health care workers. This article draws from 40 interviews conducted with intensive care unit (ICU) staff in units that were overwhelmed with COVID-19 patients. The study participants were recruited from two suburban community hospitals in Massachusetts and the interviews were conducted between January and May 2021. The results show that the uncertainty over how to treat critically ill COVID-19 patients, given the absence of standard protocols combined with ineffective treatments that led to an unprecedented number of deaths caused significant emotional pain, characterized by a visceral, embodied experience that signaled moral distress, emotional exhaustion, depersonalization, and burnout. Furthermore, ICU workers' occupational identities were undermined as they confronted the limits of their own abilities and the limits of medicine more generally. The inability to save incurable COVID-19 patients while giving maximal care to such individuals caused health care workers in the ICU an immense amount of emotional pain, contributing to our understanding of the social processes that generated the well-documented increase in moral distress and related measures of work-related psychological distress. While recent studies of emotional socialization among health care workers have portrayed clinical empathy as a performed interactional strategy, the results here show empathy to be more than dramaturgical and, in this context, entailed considerable risk to workers' emotional wellbeing.

Burnout levels and associated factors among Intensive Care Unit workers during the first wave of the COVID-19 pandemic in Chile: A cross-sectional study.

The COVID-19 pandemic resulted in an unpredictable healthcare crisis with a high psychological burden on healthcare workers. To evaluate burnout levels and their associated demographics and occupational factors among intensive care unit healthcare workers during the COVID-19 pandemic in a single hospital in the city of Temuco, Chile. A cross-sectional design in which a sociodemographic questionnaire and the Maslach Burnout Inventory for Human Services were sent to health care workers in a single Chilean Intensive Care Unit during the pandemic COVID-19. Burnout levels, demographic, and occupational factors are reported using descriptive statistics; correlations between burnout levels and demographic-occupational factors were analyzed using Spearman's and rank-biserial correlation coefficients; and multiple linear stepwise regression was used to assess the contribution of demographic and occupational factors to participants' burnout levels. A total of 84 participants (46 women and 38 men) were included in the analysis. Depersonalization and low personal accomplishment were evidenced in 95.2% and 98.8% of the intensive care unit healthcare workers, respectively. Emotional exhaustion was positively correlated with having children ( = 0.72; < 0.01). Age ( = 0.79; < 0.05), sex ( = 0.30; < 0.05), and prior experience in intensive care unit facilities ( = 0.71; < 0.05) were correlated with depersonalization. Feeling of personal accomplishment was positively correlated with with sex ( = 0.70; < 0.05) and type of work shift ( = 0.29; < 0.01). The intensive care unit healthcare workers in this study reported high levels of depersonalization and low feelings of personal accomplishment during an advanced stage of the COVID-19 pandemic. Older age, being female, having children, having intensive care unit experience, and working at 4th shift were factors related to burnout dimensions.

Resilience index and mental stress of nursing staff working in intensive care units during the SARS-CoV-2 coronavirus pandemic

Background. Resilience, or mental toughness, is the ability to effectively cope in challenging circumstances. High resilience levels allow for faster adaptation in extreme situations. Aim of the study. An assessment of resilience, mental stress, and self-reported work environment among nursing staff in intensive care units (ICUs) during the SARS-CoV-2 pandemic. Material and methods. The study involved 102 nursing staff working in ICUs. Data collection used the Resilience Coping Scale (RCS-25), Meister’s psychological strain scale, and an original work environment self-assessment scale. Results. The overall mean score of the respondents on the resilience scale was 74.11 points out of a possible 100, while they scored an average of 24.36 points out of 50 on the mental stress scale. Staff working in hospitals converted into infectious disease sites (p = 0.000) or in infectious hospitals with a third level of referral (p = 0.012) assessed their working environment significantly better in the context of the coronavirus disease 19 (COVID-19) pandemic. Medical staff who worked longer at their current workplace, those with longer seniority in the profession, and those who were older scored higher in the resilience areas. The younger the respondent, the more mentally stressed they were in general (rho= -0.200), in non-specific areas (rho= -0.217), and in monotony (rho= -0.211). Those who did not feel well equipped with personal protective equipment showed lower resilience. Conclusions. Respondents were characterized by average resilience and second-level mental stress, while those with higher resilience suffered lower mental stress. We recommend organizing training to strengthen mental toughness, the identification of resilience factors, and the assessment of mental stress in the work environment in the context of the ongoing pandemic. The data obtained could be used to adjust working conditions during the next pandemic. Keywords: nurse, intensive care unit, resilience, mental stress, mental strain, COVID-19.

Predictors of compassion satisfaction among healthcare professionals working in intensive care units: A cross-sectional study

ObjectiveTo determine the prevalence of compassion satisfaction, related factors, and predictors among healthcare professionals in Thai intensive care units. MethodsA cross–sectional study was conducted in 12 intensive care units at a university hospital in Thailand from August to November 2022. All nurses and doctors were invited to complete an anonymous online survey which included: the Professional Quality of Life Scale version 5, Connor-Davidson Resilience Scale, Passion Scale, Flourishing Scale, and Acceptance and Action Questionnaire. Descriptive statistics, Pearson's correlation coefficients, and hierarchical multiple regressions were used for data analysis in SPSS 28.0. ResultsA total of 178 nurses and doctors participated (92.13% nurses, 89.89% female, mean 32.10 years). Average compassion satisfaction (assessed using the Professional Quality of Life Scale) was moderate, with a mean score of 37.94 (SD = 5.58). The final regression model predicting compassion satisfaction was significant and explained 65% of the variance in compassion satisfaction, F (11, 154) = 26.00, p < 0.001. Four out of 11 predictor variables made unique statistically significant contributions to the final model: resilience (β = 0.48, p < 0.001), harmonious passion (β = 0.24, p < 0.001), being a nurse (not a doctor; β = 0.17, p < 0.05), and holding a postgraduate qualification (β = 0.10, p < 0.05). ConclusionMost healthcare professionals in critical care units have a moderate level of compassion satisfaction, which is correlated with resilience, flourishing, and harmonious passion. Resilience and harmonious passion predict compassion satisfaction. These factors are modifiable through intervention. Implication for clinical practiceAssessment of staff psychological well-being can identify those at risk for stress and impaired professional quality of life. Resilience and harmonious passion predict compassion satisfaction and can be modified through psychological interventions to promote psychological well-being and professional quality of life in healthcare workers in intensive care units.

Factors Affecting Nurses Performance Working in Intensive Care Units at Tertiary Care Hospitals Peshawar

Specialized nurses play a significant role in the capacity of standard health care across the globe. Many factors in intensive care units (ICUs) are present that could waste nurses’ time and energy. Objectives: To determine the factors affecting job performance of nursing staff working in Peshawar, Khyber Pakhtunkhwa, Pakistan. Methods: In this Descriptive Cross-sectional study, total of 325 nurses were selected through census sampling working in ICUs of five tertiary care hospitals Peshawar from May, 2021 to September 2021. The data collected by using adapted research instrument which had two parts: 1-demographic data, 2-nursing performance factors/obstacles. The data were analyzed with the descriptive and inferential statistics by using SPSS version-22. Results: The most common factors were: delay in getting medications from pharmacy (71.79%), improper patient’s beds space in ICUs (69.55%), distraction caused by the family’ members (62.82%) and insufficient space to sit down and do paper-work (57.69%). In the field of technology shortage of equipment’s (52.56%) and using equipment’s in poor condition (41.7%) were the most frequent obstacles. Gender, age and specialization in ICU is associated with factors that affect the performance of ICU nurses. Conclusions: Many obstacles such as delay in getting medication from pharmacy and having to use equipment in poor condition can be managed by simple interventions such as implementation of centralized pharmacy system as well as biomedical engineering system. Furthermore, management of policies and enhancing teamwork are needed to reduce obstacles such as inadequate information from physicians and disorganized unit.

Intensive care nurses' experiences of caring for patients during the COVID-19 pandemic based on an analysis of blog posts.

In 2019, coronavirus disease 2019 (COVID-19) broke out worldwide, leading to a pandemic. Studies have shown that COVID-19 patients in intensive care units (ICUs) require more nursing care than other patients. ICU nurses who care for patients with COVID-19 have shown signs of psychological and physical strain. The aim of this study was to illuminate ICU nurses' experiences of caring for patients with COVID-19 in ICUs during the first wave of the pandemic. A qualitative, descriptive and inductive approach was used. A total of 70 blog posts from 13 bloggers in the United States, Great Britain, Finland and Sweden were analysed using qualitative inductive manifest content analysis. The results reveal an overall theme: 'An overturned existence under extreme conditions'. Furthermore, three categories-'the virus caused changes in work and private lives', 'unreasonable demands', and to hold on to caring ideals thanks to the support of others'-and seven subcategories were identified. Caring for patients with COVID-19 during the first wave of the pandemic was demanding because of a lack of knowledge about the disease and the severity of the illness. This led to ICU nurses experiencing extreme conditions that affected various aspects of their lives. Support from colleagues and teamwork were revealed to be particularly important for how nurses dealt with the demands of working during a pandemic, as was sufficient recovery time between work shifts. Work in ICUs was challenging and demanding, even before the pandemic. This study contributes to an understanding of the complex work environment that existed in hospitals during the first wave of the COVID-19 pandemic. The knowledge obtained from this study can be used to revise working conditions and identify health interventions for ICU nurses.

Job Stress of Medical Staff Working in COVID-19 and Non-COVID -19 Intensive Care Units, Iran: A Multicentre Study

Background: The lack of any definitive treatment of COVID-19 has caused a great deal of stress in communities, especially for those fighting in the front line. In the present study, job stress of medical staff working in Intensive Care Units (ICUs) of patients with COVID-19 was evaluated and compared with staff working in non-COVID-19 ICUs.&#x0D; Methods: This study was performed in Iran with a study population of 80 staff members including nurses, paramedics, supervisors and other medical staff working in ICUs of COVID-19 and non-COVID-19 patients. The Osipow questionnaire was used to assess the job stress level.&#x0D; Results: The mean age of medical staff was 29.72±7.58 years old. The stress score of the male medical staff of ICUs of patients with COVID19 was significantly higher than the female staff and the average stress of employees in night shifts (190.60) was significantly higher than those in the morning and afternoon shifts. In the dimension of responsibility for COVID-19 ICU employees, working in the service department, having a history of COVID-19 infection, working in the NICU and having first-degree relatives with COVID19 caused significantly higher job stress levels. In the dimension of responsibility for non-COVID-19 ICU employees, working in the clinical ward and in the role of boundary dimension, being a supervisor caused significantly higher job stress levels compared to the rest of the staff.&#x0D; Conclusion: It can be concluded that ICU staff are under high pressure during the COVID-19 pandemic in different hospitals of Iran and they need more support to improve their mental health.

Occupational differences in COVID-19 incidence, severity, and mortality in the United Kingdom: Available data and framework for analyses.

There are important differences in the risk of SARS-CoV-2 infection and death depending on occupation. Infections in healthcare workers have received the most attention, and there are clearly increased risks for intensive care unit workers who are caring for COVID-19 patients. However, a number of other occupations may also be at an increased risk, particularly those which involve social care or contact with the public. A large number of data sets are available with the potential to assess occupational risks of COVID-19 incidence, severity, or mortality. We are reviewing these data sets as part of the Partnership for Research in Occupational, Transport, Environmental COVID Transmission (PROTECT) initiative, which is part of the National COVID-19 Core Studies. In this report, we review the data sets available (including the key variables on occupation and potential confounders) for examining occupational differences in SARS-CoV-2 infection and COVID-19 incidence, severity and mortality. We also discuss the possible types of analyses of these data sets and the definitions of (occupational) exposure and outcomes. We conclude that none of these data sets are ideal, and all have various strengths and weaknesses. For example, mortality data suffer from problems of coding of COVID-19 deaths, and the deaths (in England and Wales) that have been referred to the coroner are unavailable. On the other hand, testing data is heavily biased in some periods (particularly the first wave) because some occupations (e.g. healthcare workers) were tested more often than the general population. Random population surveys are, in principle, ideal for estimating population prevalence and incidence, but are also affected by non-response. Thus, any analysis of the risks in a particular occupation or sector (e.g. transport), will require a careful analysis and triangulation of findings across the various available data sets.

TRAUMATIC STRESS AND HEALTH ANXIETY IN INTENSIVECARE WORKERS DURING THE COVID-19 PANDEMIC

Aims: Intensive care professionals are the individuals who are most exposed to the psychological effects of the COVID-19 pandemic&#x0D; The aim of the present study was to evaluate and compare the, traumatic stress symptoms and health anxiety in intensive care unit (ICU) workers and non-ICU workers who have been playing an active role in caring for COVID-19 patients.&#x0D; Method: The sociodemographic characteristics of all the healthcare professionals working in the ICU and other units, were recorded. In addition, their history of COVID-19 infection, living with an elderly person, intensive care hospitalization history of relatives, and death status of relatives due to COVID-19 were recorded. The participants were divided into two groups, namely ICU workers and non-ICU workers. The Health Anxiety Inventory (HAI)and the Impact of Event Scale-Revised (IES-R) scales were applied to all the participants.&#x0D; Results: Of the 150 healthcare workers initially identified, 116 agreed to participate in this study. Sixty-nine (59.5%) of them were working in the ICU, while 47 (40.5%) were in non-ICU. &#x0D; The mean IES-R score of all participants was 40.19 ± 15.73. When the IES-R scores and ICU results with non-ICUs were compared, the healthcare workers who work in ICU had significantly higher total IES-R scores (42.83 ± 14.65, p