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Bruyneel A, Bouckaert N, Pirson M, Sermeus W, Van den Heede K. Unfinished nursing care in intensive care units and the mediating role of the association between nurse working environment, and quality of care and nurses' wellbeing. Intensive Crit Care Nurs 2024; 81:103596. [PMID: 38043435 DOI: 10.1016/j.iccn.2023.103596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 11/13/2023] [Accepted: 11/17/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVES Unfinished care refers to the situation in which nurses are forced to delay or omit necessary nursing care. The objectives was: 1) to measure the prevalence of unfinished nursing care in intensive care units during the COVID-19 pandemic; 2) to examine whether unfinished nursing care has a mediating role in the relationship between nurse working environment and nurse-perceived quality of care and risk of burnout among nurses. DESIGN A national cross-sectional survey. SETTING Seventy-five intensive care units in Belgium (December 2021 to February 2022). MAIN OUTCOME MEASURES The Practice Environment Scale of the Nursing Work Index was used to measure the work environment. The perception of quality and safety of care was evaluated via a Likert-type scale. The risk of burnout was assessed using the Maslach Burnout Inventory scale. RESULTS A total of 2,183 nurse responses were included (response rate of 47.8%). Seventy-six percent of nurses reported at least one unfinished nursing care activity during their last shift. The staffing and resource adequacy subdimension of the Practice Environment Scale of the Nursing Work Index had the strongest correlation with unfinished nursing care. An increase in unfinished nursing care led to significantly lower perceived quality and safety of care and an increase in high risk of burnout. Unfinished nursing care appears to be a mediating factor for the association between staffing and resource adequacy and the quality and safety of care perceived by nurses and risk of burnout. CONCLUSIONS Unfinished nursing care, which is highly related to staffing and resource adequacy, is associated with increased odds of nurses being at risk of burnout and reporting a lower level of perceived quality of care. IMPLICATIONS FOR CLINICAL PRACTICE The monitoring of unfinished nursing care in the intensive care unit is an important early indicator of problems related to adequate staffing levels, the well-being of nurses, and the perceived quality of care.
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Affiliation(s)
- Arnaud Bruyneel
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium.
| | | | - Magali Pirson
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium
| | - Walter Sermeus
- KU Leuven Institute for Healthcare Policy, Leuven, Belgium
| | - Koen Van den Heede
- Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium; KU Leuven Institute for Healthcare Policy, Leuven, Belgium
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Poiroux L, Bruyneel A, Larcin L, Fossat G, Kamel T, Labro G, Goursaud S, Rouze A, Heming N, Hermann B. Barriers to research findings utilization amongst critical care nurses and allied health professionals: An international survey. Intensive Crit Care Nurs 2024; 81:103610. [PMID: 38171952 DOI: 10.1016/j.iccn.2023.103610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 11/16/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES To determine the perceived barriers to the implementation of research findings in clinical practice among critical care nurses and allied health professionals. METHODS A cross-sectional study was conducted using an online questionnaire sent to critical care nurses and allied health professionals in French-speaking countries. The primary objective was the identification and grading of perceived barriers to implementation of research findings into clinical practice, using a previously validated tool (French version of the BARRIERS scale). The scale is divided into 4 dimensions, each containing 6 to 7 questions to be answered using a 4-point Likert scale (1: no barrier, 4: great barrier). Descriptive statistics were performed and weighted score per dimensions were compared. Univariate and multivariate linear regressions were performed to identify factors associated with the total score by dimension. RESULTS A total of 994 nurses and allied health professionals (85.1 % of ICU nurses) from 5 countries (71.8 % from France) responded to the survey. Main reported barriers to research findings utilization were "Statistical analyses are not understandable" (54.5 %), "Research articles are not readily available" (54.3 %), and "Implications for practice are not made clear" (54.2 %). Weighted scores differed between dimensions, with the "communication" and "organization" dimensions being the greatest barriers (median [IQR]: 2.3 [1.8-2.7] and 2.0 [1.6-2.4], while the "adopter" and "innovation" dimensions having lower scores (1.5 [1.2-1.8] and 1.5 [1.0-1.8] (all pairwise comparisons p-value < 0.0001, except for the adopter vs. innovation comparison, p > 0.05). CONCLUSIONS Accessibility and understanding of research results seem to be the main barriers to research utilization in practice by respondents. A large number of the reported barriers could be overcome through education and organizational change. IMPLICATIONS FOR PRACTICE Promoting a research culture among nurses and allied health professionals is an issue that needs investment. This should include training in critical reading of scientific articles and statistics.
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Affiliation(s)
- Laurent Poiroux
- Medical intensive care unit, University Hospital of Angers, France; Nursing Department Health Faculty of the University of Angers - Inserm UMR 1085 - Equipe d'épidémiologie en santé au travail et ergonomie (ESTER), France
| | - Arnaud Bruyneel
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium.
| | - Lionel Larcin
- Research Centre for Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université Libre de Bruxelles, Belgium
| | - Guillaume Fossat
- Medical Intensive Care Unit, Regional Hospital Centre, Orléans, France; UR 20201, Equipe de Recherché Paramédicale sur le Handicap Neuromoteur (ERPHAN), université Versailles Saint-Quentin en Yvelines, France
| | - Toufik Kamel
- Medical Intensive Care Unit, Regional Hospital Centre, Orléans, France
| | - Guylaine Labro
- Medical Intensive Care Unit, Groupement Hospitalier Régional Mulhouse Et Sud Alsace, Hôpital Emile Muller, Mulhouse, France
| | | | - Anahita Rouze
- University Lille, Inserm U1285, CHU Lille, Medical Intensive Care Unit, CNRS, UMR 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, F-59000 Lille, France
| | - Nicholas Heming
- Department of Intensive Care, Hôpital Raymond Poincaré, APHP University Versailles Saint Quentin-University Paris Saclay, 92380 Garches, France; Laboratory of Infection & Inflammation-U1173, School of Medicine Simone Veil, University Versailles Saint Quentin-University Paris Saclay, INSERM, 92380 Garches, France; FHU SEPSIS (Saclay and Paris Seine Nord Endeavour to PerSonalize Interventions for Sepsis), 92380 Garches, France
| | - Bertrand Hermann
- Medical Intensive Care Unit, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université Paris Cité (APHP.Centre-Université Paris Cité), Paris, France; INSERM UMR 1266, Institut de Psychiatrie et Neurosciences de Paris (IPNP), Université Paris Cité, Paris, France
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Bruyneel A, Miesse I, Mathieu D, Djuidjé Yuemo C, Simon A. Prevalence and factors associated with methicillin-resistant Staphylococcus aureus colonization on admission to geriatric care units: impact on screening practices. J Hosp Infect 2024; 146:109-115. [PMID: 38309666 DOI: 10.1016/j.jhin.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/04/2024] [Accepted: 01/14/2024] [Indexed: 02/05/2024]
Abstract
OBJECTIVES Universal screening for methicillin-resistant Staphylococcus aureus (MRSA) entails additional costs, and there is no consensus for targeted screening for high-risk units. The aims of this study were to determine the prevalence of MRSA in geriatric care units, and to identify the factors associated with MRSA colonization on admission. METHODS This retrospective case-control study (1:1) in the geriatric care unit of six Belgian hospitals covered the period from 1st January 2021 to 31st December 2022. Cases were patients with a positive MRSA screening result within 48 h of admission to the geriatric care unit, and controls were patients with a negative screening result. RESULTS In total, 556 patients were included in this study (278 in each group). Prevalence per 100 admissions for the total sample was 2.3 [95% confidence interval (CI) 2.2-2.6]. Significant multi-variate factors associated with MRSA carriage on admission were: history of MRSA, nursing home origin, and chronic skin lesions. Applying these three factors would give an area under the receiver operating characteristic (ROC) curve of 0.73 (95% CI 0.71-0.77), and would allow screening to be carried out in only 55.4% of cases (95% CI 51.2-59.6%). CONCLUSIONS Using these factors as screening criteria in geriatric care units could significantly reduce the number of patients screened for MRSA, while maintaining satisfactory sensitivity and specificity.
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Affiliation(s)
- A Bruyneel
- Hospital Outbreak Support Team, Réseau Hospitalier Universitaire Cœur de Wallonie, Belgium; Health Economics, Hospital Management and Nursing Research Department, School of Public Health, Université Libre de Bruxelles, Belgium.
| | - I Miesse
- Hospital Outbreak Support Team, Réseau Hospitalier Universitaire Cœur de Wallonie, Belgium
| | - D Mathieu
- Hospital Outbreak Support Team, Réseau Hospitalier Universitaire Cœur de Wallonie, Belgium; Infectiology - Infection Prevention and Control Department, CHU Tivoli, La Louviere, Belgium
| | | | - A Simon
- Infection Control Team, CHU HELORA, Belgium
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Bruyneel A, Larcin L, Martins D, Van Den Bulcke J, Leclercq P, Pirson M. Cost comparisons and factors related to cost per stay in intensive care units in Belgium. BMC Health Serv Res 2023; 23:986. [PMID: 37705056 PMCID: PMC10500739 DOI: 10.1186/s12913-023-09926-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/16/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Given the variability of intensive care unit (ICU) costs in different countries and the importance of this information for guiding clinicians to effective treatment and to the organisation of ICUs at the national level, it is of value to gather data on this topic for analysis at the national level in Belgium. The objectives of the study were to assess the total cost of ICUs and the factors that influence the cost of ICUs in hospitals in Belgium. METHODS This was a retrospective cohort study using data collected from the ICUs of 17 Belgian hospitals from January 01 to December 31, 2018. A total of 18,235 adult ICU stays were included in the study. The data set was a compilation of inpatient information from analytical cost accounting of hospitals, medical discharge summaries, and length of stay data. The costs were evaluated as the expenses related to the management of hospital stays from the hospital's point of view. The cost from the hospital perspective was calculated using a cost accounting analytical methodology in full costing. We used multivariate linear regression to evaluate factors associated with total ICU cost per stay. The ICU cost was log-transformed before regression and geometric mean ratios (GMRs) were estimated for each factor. RESULTS The proportion of ICU beds to ward beds was a median [p25-p75] of 4.7% [4.4-5.9]. The proportion of indirect costs to total costs in the ICU was 12.1% [11.4-13.3]. The cost of nurses represented 57.2% [55.4-62.2] of direct costs and this was 15.9% [12.0-18.2] of the cost of nurses in the whole hospital. The median cost per stay was €4,267 [2,050-9,658] and was €2,160 [1,545-3,221] per ICU day. The main factors associated with higher cost per stay in ICU were Charlson score, mechanical ventilation, ECMO, continuous hemofiltration, length of stay, readmission, ICU mortality, hospitalisation in an academic hospital, and diagnosis of coma/convulsions or intoxication. CONCLUSIONS This study demonstrated that, despite the small proportion of ICU beds in relation to all services, the ICU represented a significant cost to the hospital. In addition, this study confirms that nursing staff represent a significant proportion of the direct costs of the ICU. Finally, the total cost per stay was also important but highly variable depending on the medical factors identified in our results.
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Affiliation(s)
- Arnaud Bruyneel
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium.
| | - Lionel Larcin
- Research Centre for Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Dimitri Martins
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Julie Van Den Bulcke
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Pol Leclercq
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Magali Pirson
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
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Tack J, Bruyneel A, Bouillon Y, Taton O, Taccone F, Pirson M. Analysis of Nursing Staff Management for a Semi-intensive Pulmonology Unit During the COVID-19 Pandemic Using the Nursing Activities Score. Dimens Crit Care Nurs 2023; 42:286-294. [PMID: 37523728 DOI: 10.1097/dcc.0000000000000593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVES During the COVID-19 pandemic, a shortage of intensive care unit beds was encountered across Europe. Opening a semi-intensive pulmonary ward freed up intensive care unit beds. This study aimed to determine the appropriate nurse staffing level for a semi-intensive pulmonology unit (SIPU) for patients with COVID-19 and to identify factors associated with an increase in nursing workload in this type of unit. METHODS This was a retrospective study of the SIPU of the Erasme university clinics in Belgium. Nursing staff was determined with the Nursing Activities Score (NAS) during the second wave of COVID-19 in Belgium. RESULTS During the study period, 59 patients were admitted to the SIPU, and a total of 416 NAS scores were encoded. The mean (±SD) NAS was 70.3% (±16.6%). Total NAS varied significantly depending on the reason for admission: respiratory distress (mean [SD] NAS, 71.6% [±13.9%]) or critical illness-related weakness (65.1% ± 10.9%). The items encoded were significantly different depending on the reason for admission. In multivariate analysis, body mass index > 30 (odds ratio [OR], 1.77; 95% confidence interval [CI], 1.07-3.30) and higher Simplified Acute Physiology Score II score (OR, 1.05; 95 CI, 1.02-1.11) were associated with higher NAS. Patients admitted via the emergency department (OR, 2.45; 95% CI, 1.15-5.22) had higher NAS. Patients on noninvasive ventilation (OR, 13.65; 95% CI, 3.76-49.5) and oxygen therapy (OR, 4.29; 95% CI, 1.27-14.48) had higher NAS. High peripheral venous oxygen saturation (OR, 0.86; 95% CI, 0.78-0.94) was a predictor of lower workload. CONCLUSION A ratio of 2 nurses to 3 patients is necessary for SIPU care of patients with COVID-19. Factors associated with higher workload were high Simplified Acute Physiology Score II score, body mass index > 30, admission via emergency room, patients on oxygen, and noninvasive ventilation.
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Baudewyns V, Bruyneel A, Smith P, Servotte J, Dancot J. Prevalence and factors associated with academic burnout risk among nursing and midwifery students during the COVID-19 pandemic: A cross-sectional study. Nurs Open 2022; 10:3232-3242. [PMID: 36565163 PMCID: PMC9880668 DOI: 10.1002/nop2.1575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 04/29/2022] [Accepted: 12/10/2022] [Indexed: 12/25/2022] Open
Abstract
AIM The aim of the study was to assess the prevalence of academic burnout (AB) and its associated factors among nursing and midwifery students during the COVID-19 pandemic. DESIGN A correlational cross-sectional study. METHODS An online survey was distributed from November to December 2020 to nursing and midwifery students in Belgium. The risk of AB was assessed using the MBI-SS Academic Burnout Inventory scale. Factors associated with AB were related to the personal life and level of education of the student and to the COVID-19 pandemic. RESULTS The prevalence of overall AB risk was 50.0% (95% CI 48.5-53.1). Factors significantly associated with higher risk of AB were having a child, having a job, the level of academic training, working overtime, insufficient personal protective equipment against viral contamination during the last internship, work overload due to the pandemic, personal proven or possible SARS-CoV-2 infection and having a relative who died related to COVID-19.
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Affiliation(s)
- Véronique Baudewyns
- Nursing Department, Haute Ecole GaliléeBrusselsBelgium,Department of Epidemiology and public health, SciensanoBrusselsBelgium,Research Center for Health Economics, Management of Health Care Institutions and Nursing Sciences (CREGISI),School of Public Health, Université Libre de BruxellesBrusselsBelgium
| | - Arnaud Bruyneel
- Health Department, Haute Ecole Libre de Bruxelles – Ilya PrigogineSciensanoBrusselsBelgium
| | - Pierre Smith
- Health Economics, Hospital Management and Nursing Research Department, School of Public HealthUniversité Libre de BruxellesBrusselsBelgium,Institute of Health and Society (IRSS)Université Catholique de LouvainBrusselsBelgium
| | | | - Jacinthe Dancot
- Nursing Department, Haute Ecole Robert SchumanBelgium,Department of Public HealthUniversité de LiègeLiegeBelgium
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Bruyneel A, Larcin L, Tack J, Van Den Bulke J, Pirson M. Association between nursing cost and patient outcomes in intensive care units: A retrospective cohort study of Belgian hospitals. Intensive Crit Care Nurs 2022; 73:103296. [PMID: 35871959 DOI: 10.1016/j.iccn.2022.103296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/07/2022] [Accepted: 06/28/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Hospitals with better nursing resources report more favourable patient outcomes with almost no difference in cost as compared to those with worse nursing resources. The aim of this study was to assess the association between nursing cost per intensive care unit bed and patient outcomes (mortality, readmission, and length of stay). METHODOLOGY This was a retrospective cohort study using data collected from the intensive care units of 17 Belgian hospitals from January 01 to December 31, 2018. Hospitals were dichotomized using median annual nursing cost per bed. A total of 18,235 intensive care unit stays were included in the study with 5,664 stays in the low-cost nursing group and 12,571 in the high-cost nursing group. RESULTS The rate of high length of stay outliers in the intensive care unit was significantly lower in the high-cost nursing group (9.2% vs 14.4%) compared to the low-cost nursing group. Intensive care unit readmission was not significantly different in the two groups. Mortality was lower in the high-cost nursing group for intensive care unit (9.9% vs 11.3%) and hospital (13.1% vs 14.6%) mortality. The nursing cost per intensive care bed was different in the two groups, with a median [IQR] cost of 159,387€ [140,307-166,690] for the low-cost nursing group and 214,032€ [198,094-230,058] for the high-cost group. In multivariate analysis, intensive care unit mortality (OR = 0.80, 95% CI: 0.69-0.92, p < 0.0001), in-hospital mortality (OR = 0.82, 95% CI: 0.72-0.93, p < 0.0001), and high length of stay outliers (OR = 0.48, 95% CI: 0.42-0.55, p < 0.0001) were lower in the high-cost nursing group. However, there was no significant effect on intensive care readmission between the two groups (OR = 1.24, 95% CI: 0.97-1.51, p > 0.05). CONCLUSIONS This study found that higher-cost nursing per bed was associated with significantly lower intensive care unit and in-hospital mortality rates, as well as fewer high length of stay outliers, but had no significant effect on readmission to the intensive care unit. .
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Affiliation(s)
- Arnaud Bruyneel
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium; CHU Tivoli, La Louvière, Belgium. https://twitter.com/@ArnaudBruyneel
| | - Lionel Larcin
- Research Centre for Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université Libre de Bruxelles, Belgium
| | - Jérôme Tack
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium; Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Belgium
| | - Julie Van Den Bulke
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium
| | - Magali Pirson
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium
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Duprez F, Bruyneel A, Vanhelleputte K, Meurant V, Raquet B, Dupriez F, de Terwangne C, Tortora R, Jacques JM, Greef JD, Poncin W. Comparison of the Arterial Oxygenation Between Two Oxygen Masks. Respir Care 2022; 67:respcare.09898. [PMID: 35853709 PMCID: PMC9994031 DOI: 10.4187/respcare.09898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Frédéric Duprez
- Department of Intensive Care, Epicura Hospital, Hornu, Belgium; and Laboratory of Motion and Pulmonary Physiology, Provincial School of Hainaut HEPH-Condorcet, Tournai, Belgium.
| | - Arnaud Bruyneel
- Health Economics, Hospital Management and Nursing Research Department, School of Public Health, Université Libre de Bruxelles, Campus Erasme, Brussels, Belgium
| | | | | | | | - Florence Dupriez
- Service des urgences, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | | | - Redente Tortora
- Department of Emergency Care, Epicura Hospital, Hornu, Belgium
| | | | - Julien De Greef
- Service de médecine interne et maladies infectieuses, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - William Poncin
- Institut de recherche expérimentale et clinique, pôle de Pneumologie, ORL et Dermatologie, Université Catholique de Louvain, Brussels, Belgium; Service de Pneumologie, Cliniques universitaires Saint-Luc, Brussels, Belgium; and Secteur de Kinésithérapie et Ergothérapie, Cliniques universitaires Saint-Luc, Brussels, Belgium
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Duprez F, De Terwangne C, Poncin W, Bruyneel A, De Greef J, Wittebole X. A Modified Aerosol Mask Could Significantly Save Oxygen Supplies during SARS COV 2 Pandemic. J Emerg Nurs 2022; 48:248-250. [PMID: 35526872 PMCID: PMC9069806 DOI: 10.1016/j.jen.2021.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/03/2021] [Accepted: 08/05/2021] [Indexed: 01/09/2023]
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Khan Y, Bruyneel A, Smith P. “Determinants of the risk of burnout among nurses during the first wave of the COVID‐19 pandemic in Belgium: A cross‐sectional study”. J Nurs Manag 2022; 30:1125-1135. [PMID: 35403282 PMCID: PMC9115243 DOI: 10.1111/jonm.13624] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 02/04/2022] [Accepted: 04/04/2022] [Indexed: 12/01/2022]
Abstract
Aims To estimate the prevalence of burnout risk among nurses during the peak of the first wave of the COVID‐19 pandemic in Belgium and to identify risk groups and protective and risk factors. Background Nurses are at high risk of burnout, and this can have negative consequences for them, patients and health care systems. The pandemic may have changed their working conditions and increased their risk of burnout. Methods The risk of burnout was assessed through the Maslach Burnout Inventory Scale. Information on socio‐demographic and working conditions during the pandemic was also collected. We obtained 4552 respondents through convenience sampling. Results A high risk of burnout was found in 70% of respondents. The main risk factors of burnout were the lack of personal protective equipment, changes in perceived workload and working with COVID‐19 patients. Conclusions An uneven workload for nurses is an underlying problem during the COVID‐19 pandemic and a significant risk factor for their burnout. The decreased workload is a risk factor for burnout as important as increased workload and repeated exposure to COVID‐19. Implications for Nursing Management Burnout prevention and treatment interventions must target the correct risk factors and identify nurses at risk to be cost‐effective.
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Affiliation(s)
- Yasmine Khan
- Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Campus UZ‐Ghent, Entrance 42, 6 Floor, Corneel Heymanslaan Gent Belgium
| | - Arnaud Bruyneel
- École de Santé Publique, Campus Erasme ‐ Bâtiment A Bruxelles Belgium
| | - Pierre Smith
- Department Epidemiology and public health, Sciensano Brussels Belgium
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium Brussels Belgium
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Abstract
BACKGROUND The delivery of a high and consistent [Formula: see text] is imperative to treat acute hypoxemia. The objective of this study was to analyze the effective inspired oxygen concentration delivered by different low-flow oxygen therapy systems challenged with different oxygen flows and respiratory patterns in an experimental lung model. METHODS An adult lung model ventilated in volume control mode simulated different respiratory patterns to obtain mean inspiratory flow of 22.5, 30.0, 37.5, or 45.0 L/min. The oxygen concentration sampled inside the lung model by nasal cannula, simple face mask, non-rebreather mask, and double-trunk mask above nasal cannula tested at oxygen flows of 10, 12.5, and 15 L/min was quantified. The 3 masks were sealed tight onto the model's airway opening. They were also tested with standardized leaks to determine their clinical performance. RESULTS All oxygen delivery systems delivered higher oxygen concentration with increasing oxygen flows, regardless of the respiratory pattern. Within each device, the increase in inspiratory flow decreased oxygen concentration when using nasal cannula (P = .03), the simple face mask (P = .03), but not the non-rebreather mask (P = .051) nor the double-trunk mask (P = .13). In sealed condition, the double-trunk mask outperformed the non-rebreather mask and simple face mask (P < .001); mean oxygen concentration was 84.2%, 68.5%, and 60.8%, respectively. Leaks amplified oxygen concentration differences between the double-trunk mask and the other masks as the oxygen delivery decreased by 4.6% with simple face mask (95% CI 3.1-6.1%, P < .001), 7.8% with non-rebreather mask (95% CI 6.3-9.3%, P < .001), and 2.5% with double-trunk mask (95% CI 1-4%, P = .002). With leaks, the oxygen concentration provided by the simple face mask and the non-rebreather mask was similar (P = .15). CONCLUSIONS Lung oxygen concentration values delivered by the double-trunk mask were higher than those obtained with other oxygen delivery systems, especially when leaks were present.
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Affiliation(s)
- Frédéric Duprez
- Unité de soins intensifs, Centre Hospitalier EpiCURA, rue de Mons 63, 7301 Hornu, Belgium and Laboratoire de physiologie respiratoire, Condorcet, Tournai, Belgium
| | - Florence Dupriez
- Service des urgences, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium
| | - Julien De Greef
- Service de médecine interne et maladies infectieuses, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium
| | - Julie Gabriel
- Service de médecine interne, Centre Hospitalier EpiCURA, rue de Mons 63, 7301 Hornu, Belgium
| | - Arnaud Bruyneel
- Économie de la santé, gestion des institutions de soins et Sciences infirmières, Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium and Société des infirmier(e)s des soins intensifs, Brussels, Belgium
| | - Grégory Reychler
- Institut de recherche expérimentale et clinique (IREC), pôle de Pneumologie, ORL et Dermatologie, Université Catholique de Louvain, Avenue Hippocrate 55, 1200 Brussels, Belgium; Service de pneumologie, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium and Secteur de kinésithérapie et ergothérapie, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium
| | - Christophe De Terwangne
- Service de gériatrie, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium
| | - William Poncin
- Institut de recherche expérimentale et clinique (IREC), pôle de Pneumologie, ORL et Dermatologie, Université Catholique de Louvain, Avenue Hippocrate 55, 1200 Brussels, Belgium; Service de pneumologie, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium and Secteur de kinésithérapie et ergothérapie, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium.
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Bruyneel A, Maes J, Di Pierdomenico L, Tack J, Bogaert M, Leclercq P, Pirson M. Associations between two nursing workload scales and the cost of intensive care unit nursing staff: A retrospective study of one Belgian hospital. J Nurs Manag 2022; 30:724-732. [PMID: 34989040 DOI: 10.1111/jonm.13544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/07/2021] [Accepted: 12/29/2021] [Indexed: 11/28/2022]
Abstract
AIMS The aim of this study was to assess associations between a general nursing funding scale and an intensive care unit specific nursing workload scale and the cost of nursing staff. BACKGROUND Nurse staffing represents the most important cost in the intensive care unit, so it is essential to evaluate it accurately. In addition, the assessment of nursing workload is important for the daily management of the intensive care unit and to ensure quality of care. METHODS This was a retrospective and quantitative study carried out in the intensive care unit of a Belgian hospital. The extraction of data from the Nursing Activities Score and the Minimum Hospital Summary Nursing Dataset were carried out during 2 periods of 15 days, from 1 June 2018 to 15 June 2018 and from 1 September 2018 to 15 September 2018. RESULTS A total of 234 patients were included in the study. A total of 773 Nursing Activities Score and Minimum Hospital Summary Nursing Dataset recordings were analyzed in the study per intensive care unit day. A strong correlation was observed between Nursing Activities Score and Minimum Hospital Summary Nursing Dataset for the entire intensive care unit stay with a rho (95% CI) of .88 (0.83-.93); however, the correlation was moderate per intensive care unit day with a rho of .51 (0.45-0.57). A strong association was observed between the Minimum Hospital Summary Nursing Dataset and the Nursing Activities Score with the costs of intensive care unit nurses with a rho (95% CI) of .78 (0.72-0.86) and .74 (0.65-0.84), respectively. CONCLUSIONS A general nursing funding scale in Belgium was strongly correlated with the nursing workload for the whole intensive care unit stay, but this correlation was moderate per intensive care unit day. In contrast, both scales showed a good correlation with intensive care unit nursing costs. IMPLICATIONS FOR NURSING MANAGEMENT In Belgium, a general funding scale for nurses does not allow for an assessment of the nursing workload in the intensive care unit. The Nursing Activities Score is strongly correlated with the cost of nursing staff in the intensive care unit. The authors recommend that the Belgian authorities carry out this type of study in several intensive care units in the country and eventually replace the general funding scale for nurses with the Nursing Activities Score.
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Affiliation(s)
- Arnaud Bruyneel
- Health Economics, Hospital Management and Nursing Research Department, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium.,SIZ Nursing, A Society of Intensive Care Nurses, Belgium
| | - Julie Maes
- Simulation Laboratory for Healthcare Professions, SimLabS, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium.,Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Lionel Di Pierdomenico
- Health Economics, Hospital Management and Nursing Research Department, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium.,Medical Information Department, CHU-Charleroi Marie-Curie, Charleroi, Belgium
| | - Jérôme Tack
- Health Economics, Hospital Management and Nursing Research Department, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium.,SIZ Nursing, A Society of Intensive Care Nurses, Belgium.,Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Martin Bogaert
- Health Economics, Hospital Management and Nursing Research Department, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Pol Leclercq
- Health Economics, Hospital Management and Nursing Research Department, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Magali Pirson
- Health Economics, Hospital Management and Nursing Research Department, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
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Fattorutto M, Bouckaert Y, Brauner J, Franck S, Bouton F, Heuse D, Bouckaert C, Bruyneel A. Pragmatic study of a thromboprophylaxis algorithm in critically ill patients with SARS-COV-2 infection. J Thromb Thrombolysis 2022; 53:58-66. [PMID: 34173169 PMCID: PMC8233177 DOI: 10.1007/s11239-021-02514-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 01/08/2023]
Abstract
The optimal thromboprophylactic strategy for patients affected by Coronavirus disease 2019 (COVID-19) has been debated among experts. This study evaluated the safety and efficacy of a thromboprophylaxis algorithm. This was a retrospective, single-center study in critically ill patients admitted to the intensive care unit (University affiliated Hospital) for acute respiratory failure due to Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2). From March 16 to April 9, 2020, thromboprophylaxis was adjusted according to weight (control group, n = 19) and after this date, thromboprophylaxis depended on an algorithm based on thrombotic and hemorrhagic risk factors (protocol group, n = 13). With regard to safety (number of major bleeding events and blood transfusions), the groups were not significantly different. With regard to efficacy, the number of thrombotic events decreased from 37 to 0%, p = 0.025 after implementation of the algorithm. Also, peak fibrinogen dropped from 8.6 (7.2-9.3) to 6.5 (4.6-8.4) g/L, p = 0.041 and D-dimers from 2194 (1464-3763) to 1486 (900-2582) ng/mL, p = 0.0001. In addition, length of stay declined from 19 (10-31) to 5 (3-19) days, p = 0.009. In conclusion, a tailored thromboprophylaxis algorithm (risk stratification based on clinical parameters and biological markers) reduce thrombotic phenomena in critically ill COVID-19 patients without increasing major bleeding.
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Affiliation(s)
- Maurizio Fattorutto
- Department of Anesthesiology, Centre Hospitalier Universitaire Tivoli, Avenue Max Buset 34, 7100, La Louvière, Belgium.
| | - Yves Bouckaert
- Intensive Care Unit, Centre Hospitalier Universitaire Tivoli, La Louvière, Belgium
| | - Jonathan Brauner
- Department of Clinical Biology/Blood Bank, Centre Hospitalier Universitaire Tivoli, La Louvière, Belgium
| | - Stéphane Franck
- Intensive Care Unit, Centre Hospitalier Universitaire Tivoli, La Louvière, Belgium
| | - Fabrice Bouton
- Intensive Care Unit, Centre Hospitalier Universitaire Tivoli, La Louvière, Belgium
| | - Danielle Heuse
- Intensive Care Unit, Centre Hospitalier Universitaire Tivoli, La Louvière, Belgium
| | | | - Arnaud Bruyneel
- Intensive Care Unit, Centre Hospitalier Universitaire Tivoli, La Louvière, Belgium
- School of Public Health, Université Libre Bruxelles, Brussels, Belgium
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Lucchini A, Bambi S, Bruyneel A. Redefining "Critical care": From where intensive care unit beds are located to patients' status. Intensive Crit Care Nurs 2021; 69:103188. [PMID: 34903467 DOI: 10.1016/j.iccn.2021.103188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Alberto Lucchini
- General Intensive Care Unit, Emergency Department - ASST Monza - San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, Monza, MB, Italy.
| | - Stefano Bambi
- Department of Health Sciences - University of Florence, Italy.
| | - Arnaud Bruyneel
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium
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Bruyneel A, Lucchini A, Hoogendoorn M. Impact of COVID-19 on nursing workload as measured with the Nursing Activities Score in intensive care. Intensive Crit Care Nurs 2021; 69:103170. [PMID: 34893395 PMCID: PMC8580832 DOI: 10.1016/j.iccn.2021.103170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Arnaud Bruyneel
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium.
| | - Alberto Lucchini
- General Intensive Care Unit, Emergency Department - ASST Monza - San Gerardo Hospital, Via Pergolesi 33, Monza (MB), Italy - University of Milano-Bicocca, Italy
| | - Marga Hoogendoorn
- Department Anesthesiology and Intensive Care, Isala, Zwolle, The Netherlands
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Haegdorens F, Franck E, Smith P, Bruyneel A, Monsieurs KG, Van Bogaert P. Sufficient personal protective equipment training can reduce COVID-19 related symptoms in healthcare workers: A prospective cohort study. Int J Nurs Stud 2021; 126:104132. [PMID: 34890835 PMCID: PMC8578024 DOI: 10.1016/j.ijnurstu.2021.104132] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND The association between inadequate personal protective equipment during the COVID-19 pandemic and an increased risk of SARS-CoV-2 infection in frontline healthcare workers has been proven. However, frontline healthcare workers with an adequate supply of personal protective equipment still showed an increased risk of contracting COVID-19. Research on the use of personal protective equipment could provide insight into handling present and future pandemics. OBJECTIVES This study aims to investigate the impact of the availability, training and correct selection of personal protective equipment on the incidence of SARS-CoV-2 infection or positive suspect cases in healthcare workers during the COVID-19 pandemic in Belgium. DESIGN This was a prospective cohort study involving Belgian healthcare workers: nurses, nursing aides, and midwives working in hospitals, home care services, and residential care services. METHODS Respondents were invited from May to July 2020 (period 1) followed by a second time in October 2020 (period 2) to complete a digital survey on personal protective equipment availability, training, personal protective equipment selection, screening ability, COVID-19 testing and status, and symptoms corresponding with the COVID-19 suspect case definition. The main outcome was a composite of COVID-19 status change (from negative to positive) during the study or a positive suspect case definition in period 2. RESULTS Full data were available for 617 participants. The majority of respondents were nurses (93%) employed in a hospital (83%). In total, 379 respondents provided frontline care for COVID-19 patients (61%) and were questioned on personal protective equipment availability and personal protective equipment selection. Nurses were more likely to select the correct personal protective equipment compared with nursing aides and midwives. Respondents working in residential care settings were least likely to choose personal protective equipment correctly. Of all healthcare workers, 10% tested positive for COVID-19 during the course of the study and a composite outcome was reached in 54% of all respondents. Working experience and sufficient personal protective equipment training showed an inverse relation with the composite outcome. The relationship between personal protective equipment availability and the composite outcome was fully mediated by personal protective equipment training (-0.105 [95% confidence interval -0.211 - -0.020]). CONCLUSIONS Proper training in personal protective equipment usage is critical to reduce the risk of COVID infection in healthcare workers. During a pandemic, rapid dissemination of video guidelines could improve personal protective equipment knowledge in practitioners. Tweetable abstract: Proper training in personal protective equipment usage is critical to reduce the risk of COVID infection in healthcare workers.
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Affiliation(s)
- Filip Haegdorens
- Centre for Research and Innovation in Care (CRIC), Department of Nursing and Midwifery Sciences, University of Antwerp, Belgium.
| | - Erik Franck
- Centre for Research and Innovation in Care (CRIC), Department of Nursing and Midwifery Sciences, University of Antwerp, Belgium
| | - Pierre Smith
- Institute of Health and Society, Institut de Recherche Santé & Société (IRSS), Université Catholique de Louvain, Belgium
| | - Arnaud Bruyneel
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium
| | - Koenraad G Monsieurs
- Department of emergency medicine, Antwerp University Hospital, University of Antwerp, Belgium
| | - Peter Van Bogaert
- Centre for Research and Innovation in Care (CRIC), Department of Nursing and Midwifery Sciences, University of Antwerp, Belgium
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Butera S, Brasseur N, Filion N, Bruyneel A, Smith P. Prevalence and Associated Factors of Burnout Risk Among Intensive Care and Emergency Nurses Before and During the Coronavirus Disease 2019 Pandemic: A Cross-Sectional Study in Belgium. J Emerg Nurs 2021; 47:879-891. [PMID: 34635345 PMCID: PMC8599942 DOI: 10.1016/j.jen.2021.08.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/02/2021] [Accepted: 08/23/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION This study aimed to assess (1) the prevalence of burnout risk among nurses working in intensive care units and emergency department before and during the coronavirus disease 2019 pandemic and (2) the individual and work-related associated factors. METHODS Data were collected as part of a cross-sectional study on intensive care unit and emergency nurses in Belgium using 2 self-administered online questionnaires distributed just before the pandemic (January 2020, N = 422) and during the first peak of the pandemic (April 2020, N = 1616). Burnout was assessed with the Maslach Burnout Inventory scale. RESULTS The overall prevalence of burnout risk was higher among emergency nurses than intensive care unit nurses but was not significantly different after the coronavirus disease 2019 pandemic (from 69.8% to 70.7%, χ² = 0.15, P = .68), whereas it increased significantly among intensive care unit nurses (from 51.2% to 66.7%, χ² = 23.64, P < .003). During the pandemic, changes in workload and the lack of personal protective equipment were significantly associated with a higher likelihood of burnout risk, whereas social support from colleagues and from superiors and management were associated with a lower likelihood of burnout risk. Several determinants of burnout risk were different between intensive care unit and emergency nurses. CONCLUSION Our findings indicate that nurses in intensive care unit and emergency department were at risk of burnout but their experience during the coronavirus disease 2019 pandemic was quite different. Therefore, it is important to implement specific measures for these 2 groups of nurses to prevent and manage their risk of burnout.
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Bruyneel A, Smith P, Tack J, Pirson M. Prevalence of burnout risk and factors associated with burnout risk among ICU nurses during the COVID-19 outbreak in French speaking Belgium. Intensive Crit Care Nurs 2021; 65:103059. [PMID: 33875341 DOI: 10.1016/j.iccn.2021.103059] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Burnout is a global work-related phenomenon. Intensive care unit (ICU) nurses are at risk of burnout and the COVID-19 pandemic may increase this risk. The objectives of this study were to assess the prevalence of burnout risk and identify risk factors among ICU nurses during the COVID-19 pandemic. RESEARCH METHODOLOGY Web-based survey performed during the first wave of the COVID-19 pandemic in French speaking Belgium. MAIN OUTCOME MEASURES Risk of burnout was assessed with the Maslach Burnout Inventory scale. RESULTS A total of 1135 ICU nurses responded to the questionnaire. The overall prevalence of burnout risk was 68%. A total of 29% of ICU nurses were at risk of depersonalisation (DP), 31% of reduced personal accomplishment (PA), and 38% of emotional exhaustion (EE). A 1:3 nurse-to-patient ratio increased the risk of EE (OR = 1.77, 95% CI: 1.07-2.95) and DP (OR = 1.38, 95% CI: 1.09-2.40). Those who reported having a higher perceived workload during the COVID-19 pandemic were at higher risk for all dimensions of burnout. Shortage of personal protective equipment increased the risk of EE (OR = 1.78, 95% CI: 1.35-3.34) and nurses who reported having symptoms of COVID-19 without being tested were at higher risk of EE (OR = 1.40, 95% CI: 1.68-1.87). CONCLUSIONS Two-thirds of ICU nurses were at risk of burnout and this risk was associated with their working conditions during the first wave of the COVID-19 pandemic. We recommend monitoring the risk of burnout and implementing interventions to prevent and manage it, taking into account the factors identified in this study.
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Affiliation(s)
- Arnaud Bruyneel
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium; SIZ Nursing, A Society of Intensive Care Nurses, Belgium.
| | - Pierre Smith
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - Jérôme Tack
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium; Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Belgium
| | - Magali Pirson
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium
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Bruyneel A, Gallani MC, Tack J, d'Hondt A, Canipel S, Franck S, Reper P, Pirson M. Impact of COVID-19 on nursing time in intensive care units in Belgium. Intensive Crit Care Nurs 2020; 62:102967. [PMID: 33162312 PMCID: PMC7598359 DOI: 10.1016/j.iccn.2020.102967] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 01/15/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has had a significant impact on nursing practice in intensive care unit and consequently, on workload. OBJECTIVE To assess the nurse-patient ratio required by COVID-19 patients and to identify the factors that influence nursing in this context. DESIGN This study was a retrospective observational study that evaluated the ratio using the Nursing Activities Score (NAS). SETTING Three Belgian French-speaking hospitals, including five ICUs. Patients included COVID-19 and non-COVID-19 patients. MEASUREMENTS AND MAIN RESULTS The study included 95 COVID-19 patients and 1604 non-COVID-19 patients (control group) resulting in 905 and 5453 NAS measures, respectively. The NAS was significantly higher among the COVID-19 patients than in the control group (p = <0.0001). In the COVID-19 group, these higher scores were also observed per shift and uniformly across the three hospitals. COVID-19 patients required more time in the activities of monitoring and titration (χ2 = 457.60, p = <0.0001), mobilisation (χ2 = 161.21, p = <0.0001), and hygiene (χ2 = 557.77, p = <0.0001). Factors influencing nursing time measured by NAS in the COVID-19 patients were age <65 years old (p = 0.23), the use of continuous venovenous hemofiltration (p = 0.002), a high APACHE II score (p = 0.006) and patient death (p = 0.002). A COVID-19 diagnosis was independently associated with an increase in nursing time (OR = 4.8, 95% CI:3.6-6.4). CONCLUSIONS Patients hospitalised in the ICU due to COVID-19 require significantly more nursing time and need an average ratio of almost 1:1.
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Affiliation(s)
- Arnaud Bruyneel
- Soins intensifs - Centre Hospitalier Universitaire Tivoli, Belgium; SIZ Nursing, A Society of Intensive Care Nurses, Belgium; Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium.
| | | | - Jérôme Tack
- SIZ Nursing, A Society of Intensive Care Nurses, Belgium; Soins intensifs - Cliniques Universitaire de Bruxelles - Hôpital Erasme, Belgium
| | - Alain d'Hondt
- Soins intensifs - Centre Hospitalier Universitaire Ambroise Paré, Belgium
| | - Sebastien Canipel
- SIZ Nursing, A Society of Intensive Care Nurses, Belgium; Soins intensifs - Centre Hospitalier Universitaire Ambroise Paré, Belgium
| | - Stéphane Franck
- Soins intensifs - Centre Hospitalier Universitaire Tivoli, Belgium
| | - Pascal Reper
- Soins intensifs - Centre Hospitalier de la Haute Senne, le Tilleriau, Belgium
| | - Magali Pirson
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium
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Bruyneel A, Tack J, Droguet M, Maes J, Wittebole X, Miranda DR, Pierdomenico LD. Measuring the nursing workload in intensive care with the Nursing Activities Score (NAS): A prospective study in 16 hospitals in Belgium. J Crit Care 2019; 54:205-211. [DOI: 10.1016/j.jcrc.2019.08.032] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 08/05/2019] [Accepted: 08/29/2019] [Indexed: 01/28/2023]
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Duprez F, Bruyneel A, Machayekhi S, Droguet M, Bouckaert Y, Brimioulle S, Cuvelier G, Reychler G. The Double-Trunk Mask Improves Oxygenation During High-Flow Nasal Cannula Therapy for Acute Hypoxemic Respiratory Failure. Respir Care 2019; 64:908-914. [DOI: 10.4187/respcare.06520] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Deknuydt M, Dumont A, Bruyneel A, Dewailly D, Catteau-Jonard S. Recurrent maternal virilization during pregnancy in patients with PCOS: two clinical cases. Reprod Biol Endocrinol 2018; 16:107. [PMID: 30376853 PMCID: PMC6208071 DOI: 10.1186/s12958-018-0428-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 10/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maternal virilization during pregnancy is a rare phenomenon. Polycystic ovary syndrome (PCOS), luteoma and luteinic cysts are the most frequent and benign etiologies. This article presents two cases of recurrent maternal virilization during pregnancy. CLINICAL CASES Our reported cases were young women with Afro-Caribbean and Nigerian origins. Data were collected by history-taking, clinical examination, laboratory investigations, transabdominal ultrasonographic examination and Magnetic Resonance Imaging. Both patients were diagnosed with PCOS according to the Rotterdam criteria. During each of their pregnancies they both developed an explosive hirsutism, a deepening in the voice, a clitoromegaly. Gestational diabetes occurred during pregnancies. There was no fetal virilization, despite raising androgen levels, more than tenfold to normal. Improvement of hirsutism and normalization of androgens were described in postpartum. CONCLUSION Only few cases of maternal virilization during pregnancy were reported in literature and even fewer concern recurrent and bilateral ovarian etiology. Hyperplasia of ovarian theca cells seems to be the most likely explanation, which would suggest that PCOS belongs to a spectrum of abnormal reactivity of the ovary to human Chorionic Gonadotrophin (hCG) stimulation along with luteoma and luteinic cyst of pregnancy. Insulin resistance could worsen hyperandrogenism but is not enough to explain virilization. Treatment should focus on protecting the fetus of possible virilization as well as its mother, but also on preserving the subsequent fertility in both.
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Affiliation(s)
- M. Deknuydt
- 0000 0004 0593 6676grid.414184.cService de Gynécologie Endocrinienne et Médecine de la Reproduction, Hôpital Jeanne de Flandre, CHRU Lille, 2 Avenue Eugène Avinée, 59037 Lille, France
| | - A. Dumont
- 0000 0004 0593 6676grid.414184.cService de Gynécologie Endocrinienne et Médecine de la Reproduction, Hôpital Jeanne de Flandre, CHRU Lille, 2 Avenue Eugène Avinée, 59037 Lille, France
| | - A. Bruyneel
- 0000 0004 0594 3884grid.418052.aCentre Hospitalier de Tourcoing, 155 rue du Président René Coty, 59200 Tourcoing, France
| | - D. Dewailly
- 0000 0004 0471 8845grid.410463.4Centre Hospitalier Régional Universitaire de Lille, 2 Avenue Oscar Lambret, 59037 Lille, France
| | - S. Catteau-Jonard
- 0000 0004 0593 6676grid.414184.cService de Gynécologie Endocrinienne et Médecine de la Reproduction, Hôpital Jeanne de Flandre, CHRU Lille, 2 Avenue Eugène Avinée, 59037 Lille, France
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Bruyneel A, Guerra C, Tack J, Droguet M, Maes J, Miranda DR. Traduction sémantique en français et implémentation du Nursing Activities Score en Belgique. Méd Intensive Réa 2018. [DOI: 10.3166/rea-2018-0029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction : L’évaluation du temps de travail en soins infirmiers est une pratique courante aux soins intensifs. Elle permet de calculer un ratio infirmière/patient optimal qui est un enjeu majeur pour assurer la qualité des soins et maîtriser les coûts des soins de santé. Le Nursing Activities Score (NAS) permet de calculer ce ratio, mais l’outil n’a jamais été traduit en français et adapté à la Belgique.
Objectif : Traduire et adapter le NAS à la Belgique francophone.
Méthodes: L’échelle a été traduite par deux traducteurs indépendants de l’anglais vers le français. Ensuite, une traduction rétrograde du français à l’anglais a été réalisée. Une adaptation culturelle a été effectuée en réunissant un groupe de 13 infirmiers belges. Enfin, l’échelle traduite a été validée et implémentée dans deux unités de soins intensifs (USI) distinctes en Belgique francophone.
Résultats : La traduction rétrograde était similaire à la première traduction. La réunion avec le groupe d’experts a permis de trouver un consensus sur l’adaptation de l’échelle et le tutoriel adaptés au contexte des soins en Belgique. Pour la validation, le NAS a été encodé chez 113 patients et avec 981 NAS encodés dans deux USI, la médiane de NAS/patient était respectivement de 69 et 76 %. Le temps médian d’encodage du NAS était de trois minutes par patient. Nous avons observé une compliance élevée de l’encodage du NAS (respectivement 99 et 76 %).
Conclusions : Nous avons validé une échelle traduite en français conforme à la version originale et adaptée au contexte des soins en Belgique.
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Bruyneel A, Catteau-Jonard S, Decanter C, Clouqueur E, Tomaszewski C, Subtil D, Dewailly D, Robin G. [Polycystic ovary syndrome: what are the obstetrical risks?]. ACTA ACUST UNITED AC 2014; 42:104-111. [PMID: 24485279 DOI: 10.1016/j.gyobfe.2014.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 01/08/2014] [Indexed: 11/25/2022]
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age and the leading cause of female infertility. This condition is frequently associated with significant metabolic disorders, including obesity and hyperinsulinemia. Therefore, it seems essential to focus on the pregnancy of these patients and possible obstetric complications. Many studies suggest an increase in the risk of obstetric pathology: early miscarriage, gestational hypertension, preeclampsia, gestational diabetes mellitus diagnosed during early pregnancy, prematurity, low birthweight or macrosomia, neonatal complications and cesarean sections. However, it is difficult to conclude clearly about it, because of the heterogeneity of definition of PCOS in different studies. In addition, many confounding factors inherent in PCOS including obesity are not always taken into account and generate a problem of interpretation. However it seems possible to conclude that PCOS does not increase the risk of placental abruption, HELLP syndrome, liver disease, postpartum hemorrhage, late miscarriage and stillbirth.
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Affiliation(s)
- A Bruyneel
- Service de gynécologie endocrinienne et médecine de la reproduction, hôpital Jeanne-de-Flandre, centre hospitalier régional et universitaire de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France
| | - S Catteau-Jonard
- Service de gynécologie endocrinienne et médecine de la reproduction, hôpital Jeanne-de-Flandre, centre hospitalier régional et universitaire de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France
| | - C Decanter
- Service de gynécologie endocrinienne et médecine de la reproduction, hôpital Jeanne-de-Flandre, centre hospitalier régional et universitaire de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France
| | - E Clouqueur
- Service de pathologie maternelle et fœtale, centre hospitalier régional et universitaire de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France
| | - C Tomaszewski
- Service de gynécologie endocrinienne et médecine de la reproduction, hôpital Jeanne-de-Flandre, centre hospitalier régional et universitaire de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France
| | - D Subtil
- Service de pathologie maternelle et fœtale, centre hospitalier régional et universitaire de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France
| | - D Dewailly
- Service de gynécologie endocrinienne et médecine de la reproduction, hôpital Jeanne-de-Flandre, centre hospitalier régional et universitaire de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France
| | - G Robin
- Service de gynécologie endocrinienne et médecine de la reproduction, hôpital Jeanne-de-Flandre, centre hospitalier régional et universitaire de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France.
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Deman JJ, Bruyneel A. A correlation between the effects of calcium on intercellular adhesion and electrostatic repulsion between cells. Arch Int Physiol Biochim 1977; 85:117-24. [PMID: 68716 DOI: 10.3109/13813457709069857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Calcium ions enchance the mutual adhesiveness of HeLa cells harvested from suspension cultures in which growth is density inhibited. No significant effect of calcium is observed on the mutual adhesiveness of HeLa cells from fast growing suspension cultures. Agglutinative titration of the cells using poly-L-lysine, mol. wt 15000, shows that calcium ions reduce the strength of the repulsive forces on density inhibited HeLa cells. The agglutination curve of the nonrepulsive fast growing HeLa cells is not significantly modified by the addition of calcium. The results support the conclusion that the effect of calcium on the mutual adhesiveness of density inhibited cells is due to a weakening of the repulsive forces on these cells.
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