Assessment and Factors Associated With Cognitive Load in Orthopaedic Nurses During Bedside Handover: A Cross-Sectional Study.

AIM: To assess cognitive load status and examine factors associated with cognitive load among orthopaedic nurses during bedside handover.

DESIGN

A cross-sectional study.

METHODS

A total of 145 orthopaedic nurses from two campuses of a hospital in Shanghai were recruited using a convenience sampling method from March 2025 to June 2026. Data were collected via a general information questionnaire, the Chinese Multidimensional Cognitive Load Scale (MDT-CL), and the NASA Task Load Index (NASA-TLX). Descriptive statistics, correlation analyses, and multiple linear regression were used for data analysis.

RESULTS

The mean scores for intrinsic, extraneous, and germane cognitive load were 17.24 ± 9.03, 13.79 ± 10.02, and 32.32 ± 7.73, respectively. In the regression analysis, physical demand and frustration level were positively associated with intrinsic cognitive load, whereas team leader position, ≥ 16 years of work experience, and age ≥ 46 years were negatively associated with intrinsic cognitive load. For extraneous cognitive load, frustration level was the strongest positive predictor. For germane cognitive load, temporal demand, performance score and competency level were significant positive predictors.

CONCLUSION

Cognitive load among orthopaedic nurses during bedside handover was associated with multiple factors, including physical demand, frustration level, age, work experience, position, temporal demand, performance and competency level. These findings suggest potential targets for future intervention studies.

IMPLICATIONS FOR NURSING PRACTICE: This cross-sectional study identified factors associated with cognitive load during bedside handover among orthopaedic nurses. The findings suggest potential directions for future intervention development, including optimising workload allocation, providing targeted training and mentorship for junior nurses, fostering a supportive handover climate, and protecting adequate handover time. However, causal relationships cannot be established from this design, and the effectiveness of these strategies requires evaluation in prospective studies.

PATIENT OR PUBLIC CONTRIBUTION: The nurses spent time completing the questionnaires during the data collection phase and provided sincere responses. No patients or public were involved in the design or conduct of this study.