Evaluation of the workload of nurses caring for patients with congenital diaphragmatic hernia in a neonatal intensive care unit, according to the TISS-28 and NEMS scales

Introduction
The term “workload” has been used in the foreign literature. It is defined as a kind of power relations, active in the time of work. Exces-sive workload has been identified as a significant stressor in different professions. Nurses working in a complex, technology-related environment are exposed to a high workload. Those working in newborn intensive care units are exposed to an extremely high workload, both physically and psychologically. In the research project the measurement and analysis of nurses’ workload in the care of patients with congenital diaphragmatic hernia was conducted.

Aim of the study
The purpose of this study was to evaluate nursing workload in the care of patients with congenital diaphragmatic hernia, based on the TISS-28 (Therapeutic Intervention Simplified Scoring System-28) and the NEMS (Nine Equivalent of Nursing Manpower Score) scales.

Material and methods
The research group comprised patients with congenital diaphragmatic hernia admitted to the neonatal intensive care unit (NICU) from January 2017 to December 2017. The applied methods included participatory observation, application of two standardised scales: TISS-28 and NEMS, and documentation analysis.

Results
The average result of the measurement with the TISS-28 scale amounted to 479.5 (± SD = 47.2) points for nurses’ workload evaluation during a day of work and 480.1 (± SD = 46.0) points at night. No statistically significant differences of the analysed variables due to time of a day were found (p = 0.403). The average results of the measurement with the NEMS scale amounted to 37.9 (± SD = 5.6) points for nurses’ workload evaluation during a day of work and 36.8 (± SD = 4.9) points at night. No statistically significant differences of the analysed variables due to time of a day was found (p = 0.562). The evaluations of day workload with the TISS-28 scale correlated statis-tically significantly with the results of night workload using the same scale:  = 0.51 (p = 0.034), as well as with the results of day work-load with the NEMS scale:  = 0.91 (p < 0.001). Moreover, the measurements with the NEMS scale correlated with the results for the night workload, measured with the same scale:  = 0.65 (p = 0.005). No statistically significant correlations between the day workload measured with the TISS-28 scale and night workload measured with the NEMS scale were found, nor between the results of night work-load measured with the TISS-28 scale and both day and night workload measured with the NEMS scale.

Conclusions
Based on the results of the study, there is a high workload for nurses in the care of patients with congenital diaphragmatic hernia in the intensive care unit. There were no differences in the workload of nurses during day and night duty.