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☐ ☆ ✇ BMJ Open

Intraoperative nursing workload and associated factors: a cross-sectional analysis from two Brazilian hospital surgical units

Por: Constante · E. C. · Poveda · V. d. B. · Oliveira · R. A. — Noviembre 4th 2025 at 13:13
Objective

To estimate the workload of the nursing team and its associated factors during the intraoperative period for adult patients undergoing elective and urgent/emergency surgeries.

Design

Cross-sectional study.

Setting

Surgical units of two hospitals in Brazil.

Data sources and sample size

We prospectively assessed the workload using the National Aeronautics and Space Administration – Task Load Index (NASA-TLX) score and analysed the electronic medical records of patients who agreed to participate in the study, from November 2023 to February 2024. We included data from 116 nursing professionals and 402 surgeries.

Results

Among the procedures analysed, the median raw NASA-TLX score in cardiac surgery was significantly higher (60.8; IQR 40.0–72.5 points) compared with the others. We observed that in the generalised linear model procedures over minutes presented around 25% greater workload compared with 120 min surgeries (1.252; 95% CI 1.1018 to 1.549) and patients classified as American Society of Anesthesiologists (ASA) physical status classification (ASA) III and IV exhibited approximately 24% higher workload compared with those classified as ASA I (1.241; 95% CI 1.003 to 1.550).

Conclusions

Surgical length and ASA physical status influence the workload. Thus, we suggest that surgical unit leaders give special attention to long-term surgical procedures and patient severity on perioperative workload when dimensioning nursing staff.

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