Quantifying emergency department nursing workload at the task level using NASA-TLX: An exploratory descriptive study

Sookyung Park; Junsang Yoo; Yerim Lee; Pamela Baker DeGuzman; Min-Jeoung Kang; Patricia C Dykes; So Yeon Shin; Won Chul Cha

doi:10.1016/j.ienj.2024.101424

Quantifying emergency department nursing workload at the task level using NASA-TLX: An exploratory descriptive study

Int Emerg Nurs. 2024 Mar 25:74:101424. doi: 10.1016/j.ienj.2024.101424. Online ahead of print.

Authors

Sookyung Park¹, Junsang Yoo², Yerim Lee², Pamela Baker DeGuzman¹, Min-Jeoung Kang³, Patricia C Dykes³, So Yeon Shin⁴, Won Chul Cha⁵

Affiliations

¹ School of Nursing, University of Virginia, 225 Jeanette Lancaster Way, Charlottesville, VA 22903-3388, USA.
² Department of Digital Health, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, 115 Irwon-ro Gangnam-gu, Seoul 06355, Republic of Korea.
³ Harvard Medical School, 25 Shattuck Street, Boston MA 02115, MA, USA; Department of Medicine, Division of General Internal Medicine and Primay Care, Brigham and Women's Hospital, 1620 Tremont Street, MA, USA.
⁴ Department of Nursing, Samsung Medical Center, 81 Irwon-ro Gangnam-gu, Seoul 06351, Republic of Korea.
⁵ Department of Digital Health, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, 115 Irwon-ro Gangnam-gu, Seoul 06355, Republic of Korea; Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 115 Irwon-ro Gangnam-gu, Seoul 06355, Republic of Korea; Digital Innovation Center, Samsung Medical Center, 81 Irwon-ro Gangnam-gu, Seoul 06351, Republic of Korea. Electronic address: wc.cha@samsung.com.

PMID: 38531213
DOI: 10.1016/j.ienj.2024.101424

Abstract

Background: Emergency departments (ED) nurses experience high mental workloads because of unpredictable work environments; however, research evaluating ED nursing workload using a tool incorporating nurses' perception is lacking. Quantify ED nursing subjective workload and explore the impact of work experience on perceived workload.

Methods: Thirty-two ED nurses at a tertiary academic hospital in the Republic of Korea were surveyed to assess their subjective workload for ED procedures using the National Aeronautics and Space Administration Task Load Index (NASA-TLX). Nonparametric statistical analysis was performed to describe the data, and linear regression analysis was conducted to estimate the impact of work experience on perceived workload.

Results: Cardiopulmonary resuscitation (CPR) had the highest median workload, followed by interruption from a patient and their family members. Although inexperienced nurses perceived the 'special care' procedures (CPR and defibrillation) as more challenging compared with other categories, analysis revealed that nurses with more than 107 months of experience reported a significantly higher workload than those with less than 36 months of experience.

Conclusion: Addressing interruptions and customizing training can alleviate ED nursing workload. Quantified perceived workload is useful for identifying acceptable thresholds to maintain optimal workload, which ultimately contributes to predicting nursing staffing needs and ED crowding.