Exploring the Impact of COVID-19 on Nurse Workload and Quality of Care via Computerized Simulation

COVID-19 is taking a significant toll on front-line healthcare professionals - especially nurses who provide care for patients 24/7. Given the trend for higher acuity levels among the COVID-19 patients and increased infection prevention and control (IPAC) precautions, such as donning and doffing personal protective equipment (PPE), the demands on front-line healthcare professionals have changed. To understand the changes, discrete event simulation (DES) was used to quantify the effects of varying COVID-19 policies on nurse workload and quality of care. We are testing a standard nurse-patient ratio of 1:5 where we vary the number of COVID-19 positive patients in that mix from 1 to 5. Preliminary modeling results show as nurses were assigned to more COVID-19 positive patients, the workload of nurses increased, and quality of care deteriorated. In comparison to the baseline (pre-pandemic) case, distance walked by simulant-nurse, mental workload, direct care time, missed care, missed care delivery time and care task waiting time, increased by up to 40%, 279%, −27%, 132%, 311% and 44%, respectively. The developed approach has implications for design of the healthcare system as a whole, including pandemic planning scenarios.