Identification of the Determinants of the Perceived Workload of Nurses (CHARMIREA)

Identification of the Determinants of the Perceived Workload of Intensive Care and Pediatric Continuous Monitoring Nurses

The purpose of this study is to identify the determinants of the perceived workload of intensive care and pediatric continuous monitoring nurses (factors liked to the care service, staff, patients treated)

Study Overview

• Status: Completed
• Conditions: Nurses's Workload
• Intervention / Treatment: Behavioral: perceived workload

Detailed Description

In intensive care and pediatric continuous monitoring unit (RSCP), the workload of nurses (registered nurses) is high. It is important to distribute the workload correctly among caregivers in order to guarantee the quality and safety of care.

Workload can be measured by different means. The measure of the perceived workload has the advantage of taking into account not only the acts and care performed, but also the time pressure felt, the feeling of having been efficient in its task, the efforts made and the level of frustration felt.

Measuring the workload of RSCP registered nurses will help highlight the factors that may influence the workload. The aim is to allow an adequate distribution of patients between nurses, taking into account the determinants identified during this study.

Primary objective : Measure RSCP's nurses workload

Secondary objectives: Highlight the determinants of the overall perceived workload of RSCP nurses (organizational characteristics, of the individual, of the patient and of his entourage).

Highlight the determinants of each dimension of the perceived workload of RSCP nurses.

The calendar of data collection days will be defined by drawing lots. The day drawn for data collection will proceed normally, with no change in practice for nurses. A study investigator will inform the legal representative (s) of the possible data collection in their child that day and will trace their non-opposition in the medical file.

At the end of the day, registered nurses should collect data relating to family circles and individual characteristics. In addition, nurses must complete a NASA TLX grid for each patient treated during their working time. The grids will be assembled at the end of the day (around 7 p.m.) and handed over to an investigator. The same procedure will apply to the night shift, the grids will be handed over at 7 a.m. to an investigator.

In the following days, the principal investigator will collect the data related to the organizational characteristics and characteristics of the patients.

The perceived workload of nurses working in Intensive care and Continuous Monitoring Unit will be measured for each nurse who has at least 1 patient in charge during a period of 24 hours over 2 days (a day service and a night service, i.e. from 7 a.m. to 7 a.m. / D + 1 ), once a month for a year.

The measurement periods will be drawn at the rate of a period of 24 hours per month for one year, ie 12 periods in total.

• Study Type: Observational
• Enrollment (Actual): 484

Contacts and Locations

Study Locations

• France
  • Paris, France, 75015
    • Necker Enfants Malades hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

Nurses works in Pediatric Intensive care and Continuous Monitoring Unit of the Necker Hospital, AP-HP, Paris Child hospitalized in the Intensive care and Continuous Monitoring Unit of the Necker Hospital, AP-HP, Paris

Description

Inclusion Criteria:

• Registered nurses from Pediatric Intensive care and Continuous Monitoring Unit agreeing to participate in the study,
• Having at least one patient in charge over the period considered
• Child regardless of age hospitalized in the Pediatric Intensive care and Continuous Monitoring unit.
• Non-opposition of the legal representative (s) to the collection of data

Exclusion Criteria:

• Nurse in job adaptation training
• Interim nurse
• Nurse not usually working in intensive care
• Reference nurses of the service
• Legal guardian of the child who doesn't speak or understand French

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Task Load indeX scale (TLX scale)	TLX scale is a workload scale according to 6 dimensions: mental demands, physical demands, time pressure, performance, effort and frustration.Each dimension is evaluated on a 100-points scale. A total score from 0 to 600 points is obtained. A higher score means a worse outcome.	1 day

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Seniority in the profession	Seniority in the profession in years Seniority in the service in years Age Previous patient management (at least once in the previous 12 months) Supervision of a student Tutoring a new nurse	1 day
Seniority in the service	Seniority in the service in years Seniority in the service in years Age Previous patient management (at least once in the previous 12 months) Supervision of a student Tutoring a new nurse	1 day
Age of nurse	Age of nurse in years Day / night work Number of patient transportations Reception of an incoming patient Participation in an ethics meeting	1 day
Age of nurse	Age of nurse in years	1 day
Previous patient management	Previous patient management (at least once in the previous 12 months)	1 day
Supervision of a student	Supervision of a student (yes/no)	1 day
Tutoring a new nurse	Tutoring a new nurse (yes/no)	1 day
Ratio patient/nurse	Number of patient split by the number of nurse	1 day
Period of work	Day / night work	1 day
Patient transport	Number of patient transportations outside the ward.	1 day
New patient	Reception of an incoming patient	1 day
Ethics meeting	Participation of nurse to an ethics meeting	1 day
Age of patient	Age of patient in years	1 day
Weight of patient	Weight of patient in kilograms	1 day
Lengh of Hospitalisation	Number of days in hospital	1 day
Glasgow score	Glasgow score of patient. Scored on a total score from 3 to 15 points is obtained. A higher score means a better outcome.	1 day
Vascular supply	Type of vascular catheter present on the patient	1 day
Supportive system	Number of supportive systems necessary	1 day
Treatment	Number of treatments administered / 24 hours	1 day
Resuscitation maneuver	Resuscitation maneuver necessary (yes/no)	1 day
Death	Death of patient (yes/no)	1 day
Family support	Number of hours of presence of at least one of the two parents	1 day
Phone calls	Number of phone calls from parents	1 day
Family interview	Family interview realised ( Yes/No)	1 day

Collaborators and Investigators

• Sponsor: Assistance Publique - Hôpitaux de Paris
• Collaborators: URC-CIC Paris Descartes Necker Cochin
• Investigators: Principal Investigator: Sophie CRETE, BSc nursing, Assistance Public-Hôpitaux de Paris; Study Chair: Medhi OUALHA, MD, PhD, Assistance Public-Hôpitaux de Paris

Publications and helpful links

General Publications

• Lebet RM, Hasbani NR, Sisko MT, Agus MSD, Nadkarni VM, Wypij D, Curley MAQ. Nurses' Perceptions of Workload Burden in Pediatric Critical Care. Am J Crit Care. 2021 Jan 1;30(1):27-35. doi: 10.4037/ajcc2021725.
• Helmreich RL. On error management: lessons from aviation. BMJ. 2000 Mar 18;320(7237):781-5. doi: 10.1136/bmj.320.7237.781. No abstract available.
• Llenore E, Ogle KR. Nurse-patient communication in the intensive care unit: a review of the literature. Aust Crit Care. 1999 Dec;12(4):142-5. doi: 10.1016/s1036-7314(99)70599-0.
• Gurses AP, Carayon P, Wall M. Impact of performance obstacles on intensive care nurses' workload, perceived quality and safety of care, and quality of working life. Health Serv Res. 2009 Apr;44(2 Pt 1):422-43. doi: 10.1111/j.1475-6773.2008.00934.x. Epub 2008 Dec 16.
• Nasirizad Moghadam K, Chehrzad MM, Reza Masouleh S, Maleki M, Mardani A, Atharyan S, Harding C. Nursing physical workload and mental workload in intensive care units: Are they related? Nurs Open. 2021 Jul;8(4):1625-1633. doi: 10.1002/nop2.785. Epub 2021 Feb 17.
• Young G, Zavelina L, Hooper V. Assessment of workload using NASA Task Load Index in perianesthesia nursing. J Perianesth Nurs. 2008 Apr;23(2):102-10. doi: 10.1016/j.jopan.2008.01.008.
• Tubbs-Cooley HL, Mara CA, Carle AC, Gurses AP. The NASA Task Load Index as a measure of overall workload among neonatal, paediatric and adult intensive care nurses. Intensive Crit Care Nurs. 2018 Jun;46:64-69. doi: 10.1016/j.iccn.2018.01.004. Epub 2018 Feb 12.

Study record dates

Study Major Dates

• Study Start (Actual): June 20, 2022
• Primary Completion (Actual): November 2, 2023
• Study Completion (Actual): November 2, 2023

Study Registration Dates

• First Submitted: November 2, 2021
• First Submitted That Met QC Criteria: November 19, 2021
• First Posted (Actual): December 1, 2021

Study Record Updates

• Last Update Posted (Actual): March 30, 2026
• Last Update Submitted That Met QC Criteria: March 25, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Workload; Nurses; Intensive car unit
• Other Study ID Numbers: APHP211025; 2021-A01542-39 (Other Identifier: ID-RCB)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No