• Ruth M Lebet, Natalie R Hasbani, Martha T Sisko, AgusMichael S DMSDMichael S. D. Agus is a pediatric intensivist, endocrinologist, and chief, Division of Medical Critical Care, Boston Children's Hospital, and an associate professor, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, Vinay M Nadkarni, David Wypij, and CurleyMartha A QMAQMartha A. Q. Curley is the Ruth M. Colket Endowed Chair in Pediatric Nursing, Department of Family and Community Health, School of Nursing, University of Pennsylvania, Department of Anesthesiology and Critical Care Medicine, Perelman Sc.
• Ruth M. Lebet is a nurse scientist, Department of Pediatric Nursing Research and Evidence-Based Practice, Children's Hospital of Philadelphia, and program director for the pediatric and neonatal clinical nurse specialist programs, Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia.
• Am. J. Crit. Care. 2021 Jan 1; 30 (1): 27-35.

BackgroundQuantifying nurses' perceptions of workload burden when managing critically ill patients is essential for designing interventions to ease nurses' workday.ObjectivesTo explore pediatric intensive care unit (PICU) nurses' perceptions of their workload when caring for critically ill patients and managing protocolized therapies.MethodsThis 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.ResultsBaseline 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).ConclusionsThis study describes the workload burden perceived by PICU nurses when managing critically ill patients in general and when managing protocolized therapies.©2021 American Association of Critical-Care Nurses.

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