Volume 35, Issue 139 (December 2022)                   IJN 2022, 35(139): 478-489 | Back to browse issues page


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Asvad F, Adel Mehraban M, Rasouli M. Indirect Patient Care by Nurses in the Intensive Care Unit of a Hospital in Iran During the COVID-19 Pandemic. IJN 2022; 35 (139) :478-489
URL: http://ijn.iums.ac.ir/article-1-3590-en.html
1- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran.
2- Department of Nursing Management, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran. , adel.m@iums.ac.ir
3- Department of Epidemiology and Biostatistics, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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Introduction
In the hospital, nurses constitute the largest part of the human force, who provide their services in the form of direct and indirect patient care. They also take other responsibilities, some of which sometimes deviate them from their primary mission (i.e., patient care). In this regard and considering the prevailing conditions of the society and the COVID-19 pandemic, it is necessary to conduct studies to measure the time of providing care in intensive care units (ICUs). The ICUs during pandemic have significantly focused on electronic health systems and have different role due to the widespread prevalence of COVID-19. This study aims to determine the performance of nurses working in the ICU of Shohadaye Haft-e Tir Hospital affiliated to Iran University of Medical Sciences, during the COVID-19 pandemic.

Methods
This is a descriptive, cross-sectional, and observational study conducted in six months. The study population consists of all nurses working in the ICU of Shohadaye Haft-e Tir Hospital. Of these, 42 were randomly selected from those working in different shifts (14 form each morning, evening and night shifts). Their performance was continuously observed and their time of activities was recorded by the researcher using the stopwatch mobile application. The data collection tool was the Persian version of the International Classification for Nursing Practice (ICNP) checklist with acceptable face and content validity according to opinions of 5 faculty members and 10 nurses. It is used to record the time and frequency of patient care. In this study, due to pandemic, some items such as Washing and disinfecting hands, change or removal of personal protective equipment, and filling out the nursing report sheets, were added. Descriptive statistics (frequency, mean, standard deviation, minimum, and maximum) were used for analysis in SPSS software, version 22.

Results
Most of nurses (60%) were in the age group of 30-39 years and 72% had a work experience of 11-20 years. Most of nurses were female (85%) and married (80%). The longest time of indirect patient care was related to writing nursing reports (34.9± 10.5 minutes) and the shortest time was related to the removal of personal protective equipment (6.11±3.19 minutes). The results showed that, although patients need more direct care and continuous and active presence of nurses during the pandemic and there was advanced equipment and more facilities in the ICU, the nurses spent more time for indirect care. Nurses perform different activities during their shifts which can be eliminated to increase their time for direct care.

Conclusion
The findings of our study showed that nurses in the ICU of Shohadaye Haft-e Tir Hospital spent their most of the time for providing indirect care to COVID-19 patients. The longest time spent for indirect care was related to filling out the nursing report sheets. Before the pandemic, the findings of some studies such as Hosseinpour et al. [14], showed that the least time spent in indirect care was related to writing nursing reports (28%) and the longest time was related to patient education (73%). This can be due to the fact that the report of patient conditions is more important during the COVID-19 pandemic. In some other studies, the most of the time spent in indirect care by nurses was related to answering phones (33.3%) and answering the frequent questions of patients and their companions about the time of visit by the specialist (37. 56%). The increase in the time for proving indirect patient care compared to pre-pandemic period may be because of the fact that nurses had to do more handwashing, using personal protective equipment, and filling out more nursing report sheets. 

Ethical Considerations
Compliance with ethical guidelines

This study was approved by the ethics committee of Iran University of Medical Sciences (Code: IR.IUMS.REC.1399.1316). The information of participants were kept confidential and they were free to leave the study at any time.

Funding
This study was extracted from a master thesis in Nursing Management, Iran University of Medical Sciences and did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Authors' contributions
Conceptualization, Review & editing: Fatemeh Asvad and Marzieh Adel Mehraban; Investigation, writing, and data analysis: Fatemeh Asvad and Mahboubeh Rasouli.

Conflict of interest
The authors declare no conflict of interest.

Acknowledgments
The authors would like to thank the Personnel of Shohadaye Haft-e Tir Hospital all participants for their cooperation.

References
  1. Schneider A, Williams DJ, Kalynych C, Wehler M, Weigl M. Physicians' and nurses' work time allocation and workflow interruptions in emergency departments: A comparative time-motion study across two countries. Emerg Med J. 2021; 38(4):263-8. [DOI:10.1136/emermed-2019-208508] [PMID]
  2. Sanaeifar E, Moghri J, Mohaghegh B, Tabatabaee SS. [Estimation of Human Resources for Medical Physics Department in Iran's Largest Radiotherapy Center Based on Workload Indicators of Staffing Need: 2019 (Persian)]. J Health Adm. 2019; 22(4):106-18. [Link]
  3. Maisyaroh A, Widianto EP, Fibriansari RD. Nurses'experiences in caring for covid 19 patients. Paper presnted at: Proceeding The 4 International Agronursing Conference. 24 November 2020; Jember Regency , Indonesia. [Link]
  4. Clynch N, Kellett J. Medical documentation: Part of the solution, or part of the problem? A narrative review of the literature on the time spent on and value of medical documentation. Int J Med Inform. 2015; 84(4):221-8. [DOI:10.1016/j.ijmedinf.2014.12.001] [PMID]
  5. Tropea P, Schlieter H, Sterpi I, Judica E, Gand K, Caprino M, et al. Rehabilitation, the great absentee of virtual coaching in medical care: Scoping review. J Med Internet Res. 2019; 21(10):e12805. [PMID] [PMCID]
  6. Bambi S, Iozzo P, Lucchini A. New issues in nursing management during the COVID-19 pandemic in Italy. Am J Crit Care. 2020; 29(4):e92-e3. [DOI:10.4037/ajcc2020937] [PMID]
  7. Ashrafi-Rizi H, Kazaempour Z. [The challenges of information services related to the covid-19 crisis (Persian)]. J Mil Med. 2020; 22(2):207-9. [Link]
  8. Terry PC, Parsons-Smith RL, Terry VR. Mood responses associated with covid-19 restrictions. Front Psychol. 2020; 11:589598.[DOI:10.3389/fpsyg.2020.589598] [PMID] [PMCID]
  9. Zhou Q, Lai X, Wan Z, Zhang X, Tan L. Impact of burnout, secondary traumatic stress and compassion satisfaction on hand hygiene of healthcare workers during the COVID-19 pandemic. Nurs Open. 2021; 8(5):2551-7. [DOI:10.1002/nop2.786] [PMID] [PMCID]
  10. Udkunta K, Nantsupawat A, Thungjaroenkul P. [The study of time spent on nursing activities in operating Room, Lampang Hospital (Thai). Nurs J. 2020; 47(4):280-91. [Link]
  11. Lim ML, Ang SY. A time-motion observation study to measure and analyse clinical nursing workload in an acute care hospital in Singapore. Proc Singapore Healthc. 2019; 28(2):124-8. [DOI:10.1177/2010105819834569]
  12. Heydari F, Tabari R. [Identify direct and indirect nursing care time in a medical and surgical ward (Persian)]. J Holistic Nurs Midwifery. 2015; 25(1):1-9. [Link]
  13. Westbrook JI, Duffield C, Li L, Creswick NJ. How much time do nurses have for patients? A longitudinal study quantifying hospital nurses' patterns of task time distribution and interactions with health professionals. BMC Health Serv Res. 2011; 11:319. [PMID] [PMCID]
  14. Hoseinpoor H, Avaz Zade F, Nikbakht S, Hosseini SRS, Noorian R. Timing of nurses activities: Human resources management. Int J Med Res Health Sci. 2016; 5(11):596-600. [Link]
  15. Bradshaw KE, Sittig DF, Gardner RM, Pryor TA, Budd M. Computer-based data entry for nurses in the ICU. MD Comput. 1989; 6(5):274-80. [PMID]
  16. Norrie P. Nurses' time management in intensive care. Nurs Crit Care. 1997; 2(3):121-5. [PMID]
  17. Rouhi G, Hosseini S, Asayesh H, Behnampoor N, Rahmani H. [Relationship between nurses spent time for care and patients satisfaction in internal ward in Gorgan 5th Azar Hospital (Persian)]. Payavard Salamat. 2009; 3(2):65-74. [Link]
  18. Razu SR, Yasmin T, Arif TB, Islam MS, Islam SMS, Gesesew HA, et al. Challenges faced by healthcare professionals during the COVID-19 pandemic: A qualitative inquiry from Bangladesh. Front Public Health. 2021; 9:647315. [PMID] [PMCID]
  19. Ahmadishad M, Adib-Hajbaghery M, Rezaei M, Atoof F, Munyisia E. Care and noncare-related activities among critical care nurses: A cross-sectional observational time and motion study. Nurs Midwifery Stud. 2019; 8(1):40-7. [Link]
  20. Pilishvili T, Fleming-Dutra KE, Farrar JL, Gierke R, Mohr NM, Talan DA, et al. Interim estimates of vaccine effectiveness of Pfizer-BioNTech and Moderna COVID-19 vaccines among health care personnel-33 US sites, January-March 2021. MMWR Morb Mortal Wkly Rep. 2021; 70(20):753-8. [DOI:10.15585/mmwr.mm7020e2] [PMID] [PMCID]
  21. Neelam N, Sheorey P, Bhattacharya S, Kunte M. Organization for economic co-operation and development guidelines for learning organization in higher education and its impact on lifelong learning-evidence from Indian business schools. Vine J Inf Knowl Manag Syst. 2020; 50(4). [DOI:10.1108/VJIKMS-09-2019-0144]
  22. Gholizadeh M, Janati A, Nadimi B, Kabiri N, Abri S. How do nurses spend their time in the hospital? J Clin Res Gov. 2014; 3(1):27-33. [Link]
  23. Hejazi S, Nikbakht S, Hoseini Azizi T, Kameli A, Khosravi Pour A, RoshanNezhad M. Effect of text messaging via cell phone on critical care nurses' knowledge of ventilator-associated pneumonia. Sri Lanka: University of Kelaniya; 2022. [Link]
  24. Liu Q, Luo D, Haase JE, Guo Q, Wang XQ, Liu S, et al. The experiences of health-care providers during the COVID-19 crisis in China: A qualitative study. Lancet Glob Health. 2020; 8(6):e790-8. [DOI:10.1016/S2214-109X(20)30204-7] [PMID]
  25. Nagesh S, Chakraborty S. Saving the frontline health workforce amidst the COVID-19 crisis: Challenges and recommendations. J Glob Health. 2020; 10(1):010345. [DOI:10.7189/jogh.10.010345] [PMID] [PMCID]
Type of Study: Research | Subject: nursing
Received: 2022/06/28 | Accepted: 2022/12/22 | Published: 2022/12/22

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