Claudia-Paula Heidegger1, Séverine Graf2, Thomas Perneger3, Laurence Genton4, Taku Oshima5, Claude Pichard6. 1. Division of Intensive Care, Geneva University Hospitals, 1211 Geneva, Switzerland. Electronic address: Claudia-paula.heidegger@hcuge.ch. 2. Division of Intensive Care, Geneva University Hospitals, 1211 Geneva, Switzerland; Clinical Nutrition Unit, Geneva University Hospitals, 1211 Geneva, Switzerland. Electronic address: Severine.graf@hcuge.ch. 3. Division of Clinical Epidemiology, Geneva University Hospitals, 1211 Geneva, Switzerland. Electronic address: Thomas.perneger@hcuge.ch. 4. Clinical Nutrition Unit, Geneva University Hospitals, 1211 Geneva, Switzerland. Electronic address: Laurence.genton@hcuge.ch. 5. Clinical Nutrition Unit, Geneva University Hospitals, 1211 Geneva, Switzerland. Electronic address: Oshima.Taku@hcuge.ch. 6. Clinical Nutrition Unit, Geneva University Hospitals, 1211 Geneva, Switzerland. Electronic address: Claude.pichard@hcuge.ch.
Abstract
BACKGROUND: Diarrhea as a common complication affects 14% patients in our intensive care unit. Risk factors for diarrhea and its clinical consequences for patients are well known, but the impact of diarrhea on caregivers' workload remains undocumented. OBJECTIVES: This study aims at establishing the impact of diarrhea on costs and human burden in intensive care unit caregivers. DESIGN: A survey and observational study. SETTINGS: A mixed 36-bed medical and surgical intensive care unit. PARTICIPANTS: All intensive care unit caregivers (nurses and nursing aides). METHODS: A questionnaire was designed by a multidisciplinary team and completed by intensive care unit caregivers analyzing the clinical and human impact of diarrhea on their workload. Time measurements for the management of liquid stools were performed. Human related costs of diarrhea were analyzed according to caregivers' years of clinical experience. RESULTS: Questionnaires were completed by 146 of 204 intensive care unit caregivers (75% nurses; 73% nursing aides). Dealing with diarrhea patients is a painful aspect of their work (69% nurses) with tiredness as main feeling and a source of conflict or misunderstanding among caregivers. The mean time measurement for managing one liquid stool in 50 diarrhea episodes was 17min and 33s, involving an average of 1.4 nurses and 0.8 nursing aides. Average human resources cost burden was 26.60 CHF per liquid stool. CONCLUSION: Dealing with diarrhea increases workload for intensive care unit caregivers with consequences on their well-being. Human related costs of diarrhea are substantial and highlight the economic burden of diarrhea episodes in the intensive care unit. A multidisciplinary approach and specific protocols could positively impact the burden of diarrhea in the intensive care unit. TRIAL REGISTRATION: Clinical Trials gov NCT01922570.
BACKGROUND:Diarrhea as a common complication affects 14% patients in our intensive care unit. Risk factors for diarrhea and its clinical consequences for patients are well known, but the impact of diarrhea on caregivers' workload remains undocumented. OBJECTIVES: This study aims at establishing the impact of diarrhea on costs and human burden in intensive care unit caregivers. DESIGN: A survey and observational study. SETTINGS: A mixed 36-bed medical and surgical intensive care unit. PARTICIPANTS: All intensive care unit caregivers (nurses and nursing aides). METHODS: A questionnaire was designed by a multidisciplinary team and completed by intensive care unit caregivers analyzing the clinical and human impact of diarrhea on their workload. Time measurements for the management of liquid stools were performed. Human related costs of diarrhea were analyzed according to caregivers' years of clinical experience. RESULTS: Questionnaires were completed by 146 of 204 intensive care unit caregivers (75% nurses; 73% nursing aides). Dealing with diarrheapatients is a painful aspect of their work (69% nurses) with tiredness as main feeling and a source of conflict or misunderstanding among caregivers. The mean time measurement for managing one liquid stool in 50 diarrhea episodes was 17min and 33s, involving an average of 1.4 nurses and 0.8 nursing aides. Average human resources cost burden was 26.60 CHF per liquid stool. CONCLUSION: Dealing with diarrhea increases workload for intensive care unit caregivers with consequences on their well-being. Human related costs of diarrhea are substantial and highlight the economic burden of diarrhea episodes in the intensive care unit. A multidisciplinary approach and specific protocols could positively impact the burden of diarrhea in the intensive care unit. TRIAL REGISTRATION: Clinical Trials gov NCT01922570.
Authors: Joanna C Dionne; Kristen Sullivan; Lawrence Mbuagbaw; Alyson Takaoka; Erick Huaileigh Duan; Waleed Alhazzani; John W Devlin; Matthew Duprey; Paul Moayyedi; David Armstrong; Lehana Thabane; Jennifer L Y Tsang; Roman Jaeschke; Cindy Hamielec; Tim Karachi; Rodrigo Cartin-Ceba; John Muscedere; Mohammed Saeed Saad Alshahrani; Deborah J Cook Journal: BMJ Open Date: 2019-06-27 Impact factor: 2.692