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Observational Study
. 2022 Oct 27;63(3):E383-E390.
doi: 10.15167/2421-4248/jpmh2022.63.3.2557. eCollection 2022.

Reorganization of Intensive Care Units for the COVID-19 pandemic: effects on nursing sensitive outcomes

Nicola Pagnucci  1 , Marco Fornili  1 , Marilena Pradal  2 , Francesco Uccelli  2 , Alessandra Bovone  2 , Michele Meini  2 , Monica Scateni  2 , Laura Baglietto  1 , Francesco Forfori  3
Affiliations
Observational Study

Reorganization of Intensive Care Units for the COVID-19 pandemic: effects on nursing sensitive outcomes

Nicola Pagnucci et al. J Prev Med Hyg. .

Abstract

Background: Since the first months of 2020 COVID-19 patients who were seriously ill due to the development of ARDS, required admission to the intensive care unit to ensure potentially life-saving mechanical ventilation and support for vital functions. To cope with this emergency, an extremely rapid reorganization of premises, services and staff, to dedicate an entire intensive care unit exclusively to SARS-CoV-2 patients and increasing the number of beds was essential. The aim of the study was to evaluate the effects of reorganization of the COVID-19 intensive care unit in terms of nursing sensitive outcomes.

Methods: a retrospective observational study was conducted to compare nursing sensitive outcomes between pre-COVID period and COVID period.

Results: Falls (0.0 and 0.4%, respectively), physical restraint (1.8 and 1.1%, respectively), and pressure ulcers (8.0 and 3.0%, respectively) were similar in the COVID and in the pre-COVID group. After adjusting for gender, age, BMI, and number of comorbidities, the incidence of bloodstream infections was significantly higher in the COVID group than in the pre-COVID group. There were no statistically significant differences in the incidence between the two groups regarding other evaluated outcomes.

Conclusion: The selected nursing sensitive outcomes maintained similar values in the pre-COVID and COVID patient groups. Healthcare-related infections rate must be considered an important alarm signal of quality of nursing care especially in conditions of excessive workload, stress and the presence of less experienced staff increase.

Keywords: COVID-19; Healthcare-associated Infections; Hospital reorganization; Intensive care; Nursing outcomes; Pandemic.

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