Research Article
Volume 4 Issue 3 - 2020
The Workload in the Emergency Room: Direct Assessment by the Therapeutic Intervention Scoring System-76 and Indirect Assessment by the NASA Task Load Index
Nour Elhouda Nouira1*, Lotfi Arbi2, Wided Bahria1, Dhekra Hamdi1, Dorra Chtourou1, Monia Boussen1, Amira Lahouegue1 and Mamoun Ben Cheikh1
1Emergency Department of Mongi Slim Academic Hospital, University Tunis El Manar, Tunisia
2Directorate of Medical Inspection, Ministry of Public Health, Bab Saâdoun Tunis, Tunisia
*Corresponding Author: Nour Elhouda Nouira, Assistant Professor in Emergency Medicine Department, Mongi Slim Academic Hospital, University Tunis El Manar, Tunisia.
Received: January 21, 2020; Published: February 19, 2020


Introduction: The number of emergency room admissions continues to increase each year, which increases the care workload of the emergency department staff, who should to use its theoretical and practical knowledge in order to provide quality care in difficult working conditions.

Aim: The aim of our study was to assess the emergency room staff workload its impact on health workers and patients and to suggest an improvement strategy to decrease this workload.

Methods: A prospective, monocentric cohort study with descriptive and analytic approach over one month (December 2018) conducted at the Emergency Department of Mongi Slim academic hospital. The workload endured by the emergency room staff was evaluated by the NASA Task Load Index and on patients by the Therapeutic Intervention Scoring System-76.

Results: There were 286 cumulative days of hospitalization in 67 consecutive patients admitted to the emergency room. The average age was 61 ± 15 years. The average length of stay at the emergency room was about 103 ± 48h. The average TISS-76 score was 31.7 ± 14.9. Factors associated with important care workload were: age ≥ 65 years, diabetes, more than 3 comorbidities, the use of intravenous antibiotics; the use of vasoactive drugs and the use of mechanical ventilation; a high TISS score was predictive of emergency room mortality. In the indirect assessment of the care workload, 41 medical and paramedical staff were interviewed, 73% of them were under 40 years old with a sex ratio of 0.58. A high level of mental and physical workload was expressed by ED staff with considerable level of frustration; The ED staff suggested mainly to improve the working conditions, communication and to redefine tasks "who does what".

Conclusion: Our study had shown a significant workload in the emergency room, a process to reduce this workload is being implemented. 

Keywords: Workload; Emergency Room; Therapeutic Intervention Scoring System-76; NASA Task Load Index


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Citation: Nour Elhouda Nouira., et al. “The Workload in the Emergency Room: Direct Assessment by the Therapeutic Intervention Scoring System-76 and Indirect Assessment by the NASA Task Load Index”. EC Emergency Medicine and Critical Care 4.3 (2020): 01-09.

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