O IMPACTO DA SOBRECARGA DE TRABALHO NA ENFERMAGEM E SUAS CONSEQUÊNCIAS PARA O CUIDADO AO PACIENTE
DOI:
https://doi.org/10.56238/revgeov17n5-051Palavras-chave:
Sobrecarga de Trabalho, Burnout Ocupacional, Segurança do Paciente, Dimensionamento de Pessoal, Qualidade do CuidadoResumo
Esta revisão integrativa analisa o impacto da sobrecarga de trabalho e do burnout na enfermagem sobre a segurança do paciente e a qualidade assistencial. A escassez global de profissionais, aliada a ambientes estressantes, gera altas taxas de exaustão, que foram dramaticamente exacerbadas pela pandemia de COVID-19. O estudo demonstra de forma consistente que proporções inadequadas de pacientes por enfermeiro estão diretamente associadas ao aumento da mortalidade hospitalar, maiores taxas de readmissão e prolongamento do tempo de internação. Adicionalmente, o burnout na equipe correlaciona-se com um clima de segurança inferior e elevação de eventos adversos, englobando infecções relacionadas à assistência à saúde, erros de administração de medicamentos e a omissão de cuidados essenciais de vigilância e higiene. Contrariando a percepção de alto custo, análises econômicas evidenciam que o investimento no dimensionamento adequado da equipe apresenta retorno positivo, pois os custos são compensados pela redução de complicações. Conclui-se que a sobrecarga deve ser abordada como um fenômeno organizacional sistêmico. A adoção de políticas de proporções mínimas seguras é custo-efetiva, essencial para mitigar riscos e fundamental para preservar vidas.
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Referências
1. Effects of Nurse-to-Patient Ratio Legislation on Nurse Staffing and Patient Mortality, Readmissions, and Length of Stay: A Prospective Study in a Panel of Hospitals. McHugh MD, Aiken LH, Sloane DM, et al. Lancet (London, England). 2021;397(10288):1905-1913. doi:10.1016/S0140-6736(21)00768-6.
2. Hospital Nurse Understaffing and Patient Mortality, Readmission, and Length of Stay. Morioka N, Moriwaki M, Miyawaki A, et al. JAMA Network Open. 2026;9(2):e2558235. doi:10.1001/jamanetworkopen.2025.58235.
3. Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction. Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH. JAMA. 2002 Oct 23-30;288(16):1987-93. doi:10.1001/jama.288.16.1987.
4. Measuring the Availability of Human Resources for Health and Its Relationship to Universal Health Coverage for 204 Countries and Territories From 1990 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019. GBD 2019 Human Resources for Health Collaborators. Lancet (London, England). 2022;399(10341):2129-2154. doi:10.1016/S0140-6736(22)00532-3.
5. Hospital Nurse-Staffing Models and Patient- And Staff-Related Outcomes. Butler M, Schultz TJ, Halligan P, et al. The Cochrane Database of Systematic Reviews. 2019;4:CD007019. doi:10.1002/14651858.CD007019.pub3.
6. Global Nurse Shortages-the Facts, the Impact and Action for Change. Drennan VM, Ross F. British Medical Bulletin. 2019;130(1):25-37. doi:10.1093/bmb/ldz014.
7. Nurse Burnout and Patient Safety, Satisfaction, and Quality of Care: A Systematic Review and Meta-Analysis. Li LZ, Yang P, Singer SJ, et al. JAMA Network Open. 2024;7(11):e2443059. doi:10.1001/jamanetworkopen.2024.43059.
8. Global Prevalence of Burnout Symptoms Among Nurses: A Systematic Review and Meta-Analysis. Woo T, Ho R, Tang A, Tam W. Journal of Psychiatric Research. 2020;123:9-20. doi:10.1016/j.jpsychires.2019.12.015.
9. Global Prevalence of Nursing Burnout Syndrome and Temporal Trends for the Last 10 years: A Meta-Analysis of 94 Studies Covering Over 30 Countries. Ge MW, Hu FH, Jia YJ, et al. Journal of Clinical Nursing. 2023;32(17-18):5836-5854. doi:10.1111/jocn.16708.
10. Characteristics of Occupational Burnout Among Nurses of Various Specialties and in the Time of the COVID-19 Pandemic-Review. Ślusarz R, Cwiekala-Lewis K, Wysokiński M, et al. International Journal of Environmental Research and Public Health. 2022;19(21):13775. doi:10.3390/ijerph192113775.
11. Prevalence and Risk Factors of Burnout Symptoms Among Nurses During the COVID-19 Pandemic: An Updated Systematic Review and Meta-Analysis. Fekih-Romdhane F, Harb F, Al Banna S, Obeid S, Hallit S. Human Resources for Health. 2025;23(1):48. doi:10.1186/s12960-025-01012-4.
12. Emotional Exhaustion Among US Health Care Workers Before and During the COVID-19 Pandemic, 2019-2021. Sexton JB, Adair KC, Proulx J, et al. JAMA Network Open. 2022;5(9):e2232748. doi:10.1001/jamanetworkopen.2022.32748.
13. Patterns and Correlates of Nurse Departures From the Health Care Workforce: Results From a Statewide Survey. Medvec BR, Marriott DJ, Khadr L, et al. Medical Care. 2023;61(5):321-327. doi:10.1097/MLR.0000000000001837.
14. Nurses' Burnout and Associated Risk Factors During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis. Galanis P, Vraka I, Fragkou D, Bilali A, Kaitelidou D. Journal of Advanced Nursing. 2021;77(8):3286-3302. doi:10.1111/jan.14839.
15. Exploring the Impact of COVID-19 Pandemic on Nurses: A Cross-Sectional Study on Job Burnout and Quality of Work Life. Saleh E, Asar ME, Ghaneapur MR, Harati Asl N, Kangarlou MB. PloS One. 2025;20(10):e0331247. doi:10.1371/journal.pone.0331247.
16. What Determines Physical, Mental and Emotional Workloads on Nurses? A Cross-Sectional Study. Ivziku D, de Maria M, Ferramosca FMP, et al. Journal of Nursing Management. 2022;30(8):4387-4397. doi:10.1111/jonm.13862.
17. Prevalence of and Factors Associated With Nurse Burnout in the US. Shah MK, Gandrakota N, Cimiotti JP, et al. JAMA Network Open. 2021;4(2):e2036469. doi:10.1001/jamanetworkopen.2020.36469.
18. Changes in Registered Nurse Employment Plans and Workplace Assessments. Friese CR, Medvec BR, Marriott DJ, et al. JAMA Network Open. 2024;7(7):e2421680. doi:10.1001/jamanetworkopen.2024.21680.
19. Defining Nursing Workload Predictors: A Pilot Study. Ivziku D, Ferramosca FMP, Filomeno L, et al. Journal of Nursing Management. 2022;30(2):473-481. doi:10.1111/jonm.13523.
20. Perceptions of Nursing Workloads and Contributing Factors, and Their Impact on Implicit Care Rationing: A Queensland, Australia Study. Hegney DG, Rees CS, Osseiran-Moisson R, et al. Journal of Nursing Management. 2019;27(2):371-380. doi:10.1111/jonm.12693.
21. Is Hospital Nurse Staffing Legislation in the Public's Interest?: An Observational Study in New York State. Lasater KB, Aiken LH, Sloane DM, et al. Medical Care. 2021;59(5):444-450. doi:10.1097/MLR.0000000000001519.
22. Nursing Workload as a Risk Factor for Healthcare Associated Infections in ICU: A Prospective Study. Daud-Gallotti RM, Costa SF, Guimarães T, et al. PloS One. 2012;7(12):e52342. doi:10.1371/journal.pone.0052342.
23. Hospital Organisation, Management, and Structure for Prevention of Health-Care-Associated Infection: A Systematic Review and Expert Consensus. Zingg W, Holmes A, Dettenkofer M, et al. The Lancet. Infectious Diseases. 2015;15(2):212-24. doi:10.1016/S1473-3099(14)70854-0.
24. Overcrowding and Understaffing in Modern Health-Care Systems: Key Determinants in Meticillin-Resistant Staphylococcus Aureus Transmission. Clements A, Halton K, Graves N, et al. The Lancet. Infectious Diseases. 2008;8(7):427-34. doi:10.1016/S1473-3099(08)70151-8.
25. The Relationship Between Nurse Burnout, Missed Nursing Care, and Care Quality Following COVID-19 Pandemic. Nantsupawat A, Wichaikhum OA, Abhicharttibutra K, Sadarangani T, Poghosyan L. Journal of Clinical Nursing. 2023;32(15-16):5076-5083. doi:10.1111/jocn.16761.
26. Cost-Effectiveness of Eliminating Hospital Understaffing by Nursing Staff: A Retrospective Longitudinal Study and Economic Evaluation. Saville C, Jones J, Meredith P, Dall'Ora C, Griffiths P. BMJ Quality & Safety. 2025;:bmjqs-2024-018138. doi:10.1136/bmjqs-2024-018138.