Nurses’ Perceptions of Workload Burden in Pediatric Critical Care

Abstract

Quantifying nurses’ perceptions of workload burden when managing critically ill patients is essential for designing interventions to ease nurses’ workday. To explore pediatric intensive care unit (PICU) nurses’ perceptions of their workload when caring for critically ill patients and managing protocolized therapies. This study was embedded in a multicenter randomized clinical trial where participants were assigned to receive either lower-target or higher-target glucose control. Nurses from 35 participating PICUs completed a baseline survey containing questions about their perceptions of PICU workload in general. They completed an intervention survey after caring for a study patient. Two workload measurement instruments, the Subjective Workload Assessment Technique (SWAT) and the National Aeronautics and Space Administration–Task Load Index (NASA-TLX), were embedded in these surveys. Baseline surveys were completed by 1476 PICU nurses, predominantly female with a bachelor’s degree and a median (interquartile range) of 6 (3-11) years of nursing experience and 4 (2-9) years of PICU experience. Most nurses (65%) rated time burden as the most important component of their workload, followed by cognitive (22%) or psychological stress (13%) burden. Work performance was selected most often as contributing to workload, followed by cognitive demand, time pressure, effort, and physical demand. Intervention surveys were completed by 73% of enrolled participants (505 of 693). Nurses managing the lower glucose target group reported higher levels of workload burden as measured by the SWAT (P = .002) and NASA-TLX (P < .001). This study describes the workload burden perceived by PICU nurses when managing critically ill patients in general and when managing protocolized therapies.