Workloads in nursing activities performed in university hospitals

Cross-sectional quantitative study performed with 361 nursing workers from two University Hospitals between November 2019 and February 2020. An instrument addressing sociodemographic and occupational variables was used together with the previously validated Workloads in Nursing Activities Scale. The distribution of frequencies, measures of location, and variability were identified, and analysis of variance and the Tukey test were performed.

Results:

The construct that obtained the highest mean was F3 – Biological Loads (3.00), revealing that nursing workers are very intensively exposed to biological loads. Workloads were significantly different between the work units – physiological (p = 0.001), biological (p = 0.007), psychological (p = 0.042), mechanical (p = 0.014), chemical (p = 0.001), and physical (p = 0.001).

Conclusion:

The workers identified that exposure to workloads varies in intensity, showing aspects of the work performed in health institutions that either aggravate or mitigate workloads through the activities performed by nursing workers.

DESCRIPTORS
Workload; Nursing; Occupational Health; Hospitals, University; Nursing, Team

Variables		n	%
Hospital	H1	189	52.4
Hospital	H2	172	47.6
Sex	Female	295	81.7
Sex	Male	66	18.3
Job position	Nurse	97	26.9
	Nursing technician	233	64.5
	Nursing aid	31	8.6
Work unit	Obstetrical center	20	5.5
	Maternity	49	13.4
	Pediatric clinic	28	7.8
	Emergency care service	33	9.1
	Medical clinic unit	57	15.8
	Surgical clinic unit	31	8.6
	Surgical center	20	5.5
	General ICU	25	6.9
	Neonatal ICU	46	12.7
	Urgency and emergency network	52	14.4

Constructs	n	$\bar{X}$	DP
Construct 1 – Psychological loads	361	1.83	0.90
Q22. Excess work resulting from administrative tasks, care delivery, and teaching, research, and extension activities.	360	1.69	1.34
Q17. Lack of communication or miscommunication due to many people asking for information and difficulties communicating with the staff, students, and professors.	361	1.87	1.27
Q19. Guide and supervise the preparation of medications during the training of co-workers newly admitted to the unit, undergraduate students, or residents.	358	1.78	1.29
Q16. Perceiving and/or experiencing difficulties with teamwork, conflicts among workers, and many people in the unit (multidisciplinary teams, residents, students, and professors).	361	1.81	1.28
Q18. Living in a state of constant alertness when monitoring students performing invasive and non-invasive procedures and advising and developing research.	359	1.45	1.25
Q21. Witnessing and/or experiencing threats and psychological and/or moral violence on the part of patients, family members, or remaining health workers.	359	1.71	1.41
Q20. Experiencing tension when developing work due to inadequate staffing and intense and exhausting routines,	360	2.52	1.26
Construct 2 – Physiological loads	361	2.53	1.12
Q14. Handling excessive weight of patients, devices, and equipment.	359	2.34	1.29
Q15. Transporting patients from stretcher to bed or wheelchair, transporting patients and equipment.	360	2.60	1.30
Q12. Performing physical effort when moving patients.	356	2.71	1.24
Q13. Performing physical effort due to understaffing.	348	2.47	1.28
Construct 3 – Biological loads	361	3.00	0.95
Q11. Providing care to patients affected by microorganisms (e.g., viruses, bacteria, fungi) and patients on contact, aerosol, or droplet precautions.	361	3.17	1.14
Q10. Contact with secretions when changing dressings, tending drains or performing oral, nasal, or tracheal aspiration.	360	2.65	1.31
Q09. Performing procedures involving contact with body fluids such as feces, urine, or amniotic fluid.	361	3.08	1.18
Q05. Wearing latex gloves to perform invasive and non-invasive procedures in patients and to handle products.	361	3.13	1.20
Construct 4 – Mechanical loads	361	0.92	0.94
Q06. Experiencing physical violence on the part of companions or patients.	354	0.79	1.15
Q07. Falling due to wet floors, imperfection, or obstacles in the circulation area.	358	0.65	1.02
Q08. Experiencing accidents such as torsions, bruises, and sprains due to overload of patients and/or equipment during handling and transportation.	361	1.35	1.23
Construct 5 – Physical loads	361	1.39	1.06
Q01. Working with poor lighting, no natural light, or in the presence of burnt-out lamps.	357	1.30	1.19
Q02. Working in poor conditions, such as limited physical space, scrapped material, inadequate waste disposal, or exposure to electric shock.	359	1.49	1.30
Construct 6 – Chemical loads	361	2.36	1.10
Q04. Preparing and administering medications such as antibiotics, chemotherapy, anesthetic gases, and antiviral agents.	361	2.00	1.40
Q03. Handing products to clean and disinfect equipment and material such as formaldehyde, sodium hypochlorite, soaps, peracetic acid, and alcohol.	357	2.72	1.25

Variables	Psychological loads		Physiological loads		Biological loads		Mechanical loads		Chemical loads		Physical loads
Variables	$\bar{X}$	p	$\bar{X}$	p	$\bar{X}$	p	$\bar{X}$	p	$\bar{X}$	p	$\bar{X}$	p
Job position		0.001*		0.022*		0.002*		0.149		0.001*		0.407
Nurse	2.27		2.27		2.83		1.03		1.69		1.52
Technician	1.69		2.64		3.13		0.85		2.64		1.35
Aid	1.48		2.47		2.60		1.11		2.35		1.33
Work unit		0.042*		0.001*		0.007*		0.014*		0.001*		0.001*
OB	2.06		3.16		3.07		1.35		3.12		1.25
MAT	1.82		2.63		2.88		0.62		2.34		1.14
PC	1.78		1.74		2.46		0.94		2.01		1.51
ECS	1.48		2.28		3.00		0.83		1.95		0.78
MCU	2.04		2.92		3.25		0.99		2.37		1.35
SCU	1.56		2.81		2.99		0.79		2.11		1.04
SC	1.55		2.33		2.48		0.98		1.90		1.75
G ICU	1.70		2.96		3.14		1.44		2.16		1.72
Neo ICU	1.89		1.22		3.13		0.72		2.80		1.46
UEN	2.03		3.19		3.15		1.02		2.54		1.90

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Deciane Pintanela de Carvalho, Rua General Osório, s/n, 96200-190 – Rio Grande, RS, Brazil, deciane.carvalho@gmail.com