Burnout, resilience and work engagement among Dutch intensivists in the aftermath of the COVID-19 crisis: A nationwide survey

This article by Meynaar and others was first published in Journal of Critical Care during November 2020.
Purpose:  The COVID-19 crisis put a strain on intensive care resources everywhere in the world increasing the risk of burnout. Previously, the prevalence of burnout among Dutch intensivists was found to be low. Engagement and resilience among intensivists have not previously been studied quantitatively, however, both are related to burnout and provide a possible way to mitigate burnout. Our objective was to study burnout and its association with work engagement and resilience among Dutch intensivists in the aftermath of the COVID-19 crisis.
Methods:  An online questionnaire was sent to all Dutch intensivists. The questionnaire consisted of questions on personal and work-related characteristics and validated questionnaires: the Maslach Burnout Inventory, the Utrecht Work Engagement Scale, and the Resilience Evaluation Scale.
Results:  The response rate was 27.2% with 162 evaluable responses. Thirteen respondents (8.0%) were classified as having burnout, 63 (38.9%) respondents were reporting high work engagement. Burnout was found to be negatively associated with both work engagement and resilience.
Conclusion:  In the aftermath of the 2020 COVID-19 crisis, we found a raised prevalence of burnout among intensivists, however this is still low in international comparisons. Intensivists with burnout scored low on resilience and low on work engagement.
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Bright environmental light improves the sleepiness of night shift ICU nurses

This article by Griepentrog and others was published in Critical Care in November 2018.
Background:  Shift work can disturb circadian homeostasis and result in fatigue, excessive sleepiness, and reduced quality of life. Lighttherapy has been shown to impart positive effects in night shift workers. Wesought to determine whether or not prolonged exposure to bright light during anight shift reduces sleepiness and enhances psychomotor performance among ICUnurses.
Methods:  This is a single-center randomized, cross over clinical trial at a surgical trauma ICU. ICU nurses working a night shift were exposed to a 10-h period of high illuminance (1500-2000 lx) white light compared to standard ambient fluorescent lighting of the hospital. They then completed the Stanford Sleepiness Scale and the Psychomotor Vigilance Test. The primary and secondary endpoints were analyzed using the paired t test. Ap value <0.05 was considered significant.
Results:  A total of 43 matched pairs completed both lighting exposures and were analyzed. When exposed to high illuminance lighting subjects experienced reduced sleepiness scores on the Stanford Sleepiness Scalethan when exposed to standard hospital lighting: mean (sem) 2.6 (0.2) vs. 3.0(0.2), p = 0.03. However, they committed more psychomotor errors: 2.3 (0.2) vs.1.7 (0.2), p = 0.03.
Conclusions:  A bright lighting environment for ICU nurses working the night shift reduces sleepiness but increases the number of psychomotor errors.

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Identifying determinants of noise in a medical intensive care unit

This article by Crawford and others was published in the September 2018 issue of the Journal of Occupational and Environmental Hygiene.
Continuous and intermittent exposure to noise elevates stress, increases blood pressure, and disrupts sleep among patients in hospital intensive care units. The purpose of this study was to determine the effectiveness of a behavior-based intervention to reduce noise and to identify determinants of noise in a medical intensive care unit.  Staff were trained for six weeks to reduce noise during their activities in an effort to keep noise levels below 55 dBA during the day and below 50 dBA at night. One-min noise levels were logged continuously in patient rooms eight weeks before and after the intervention. Noise levels were compared by room position, occupancy status, and time of day. Noise levels from flagged days (>60 dBA for >10 hrs) were correlated with activity logs. The intervention was ineffective with noise frequently exceeding project goals during the day and night. Noise levels were higher in rooms with the oldest heating, ventilation, and air-conditioning system, even when patient rooms were unoccupied. Of the flagged days, the odds of noise over 60 dBA occurring was 5.3 higher when high-flow respiratory support devices were in use compared to times with low-flow devices in use (OR= 5.3, 95% CI = 5.0 – 5.5). General sources, like the heating, ventilation, and air-conditioning system, contribute to high baseline noise and high-volume (>10 L/min) respiratory-support devices generate additional high noise (>60 dBA) in Intensive Care Unit patient rooms. This work suggests that engineering controls (e.g., ventilation changes or equipment shielding) may be more effective in reducing noise in hospital intensive care units than behavior modification alone.
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