Objective: To analyze whether an increase in patient severity and nursing workload are correlated to a greater incidence of adverse events (AEs) in critical patients. Method: A prospective single cohort study was performed on a sample of 138 patients hospitalized in an intensive care unit (ICU). Results: A total of 166 AEs, occurred, affecting 50.7% of the patients. Increased patient severity presented a direct relationship to the probability of AEs occurring. However, nursing workload did not present a statistically signifi cant relationship with the occurrence of AEs. Conclusion: The results cast light on the importance of using evaluation tools by the nursing personnel in order to optimize their daily activities and focus on patient safety. Descriptors: Nursing Care; Patient Severity; Workload; Safety Management; Patient Safety. RESUMO Objetivo: Analisar se o aumento da gravidade do paciente e a carga de trabalho de enfermagem está relacionado à maior incidência de Eventos Adversos (EAs) em pacientes críticos. Método: Estudo de coorte única, prospectivo, com amostra de 138 pacientes internados em uma Unidade de Terapia Intensiva (UTI). Resultados: Ao todo, foram evidenciados 166 EAs, que acometeram 50,7% dos pacientes. O aumento da gravidade do paciente apresentou relação direta com a chance de ocorrência de EAs. Entretanto, a carga de trabalho de enfermagem não apresentou relação estatisticamente signifi cativa, na ocorrência de EAs. Conclusão: Os resultados permitem refl etir acerca da importância da equipe de enfermagem, em utilizar instrumentos de avaliação, com o objetivo de melhorar e planejar suas ações diárias, com foco na segurança do paciente. Descritores: Cuidados de Enfermagem; Gravidade do Paciente; Carga de Trabalho; Gestão da Segurança; Segurança do Paciente. RESUMENObjetivo: Analizar si el aumento de la gravedad del paciente y la carga de trabajo de enfermería está relacionada con mayor incidencia de Eventos Adversos (EAs) en pacientes críticos. Método: Estudio de cohorte única, prospectivo, con muestra de 138 pacientes internados en una Unidad de Terapia Intensiva (UTI). Resultados: En total, fueron evidenciados 166 EAs, incidiendo sobre 50,7% de los pacientes. El aumento de la gravedad del paciente mostró relación directa con la posibilidad de ocurrencia de EAs. Sin embargo, la carga de trabajo de enfermería no demostró relación estadísticamente signifi cativa en la ocurrencia de EAs. Conclusión: Los resultados permiten refl exionar sobre la importancia del equipo de enfermería, en utilizar instrumentos de evaluación, con el objeto de mejorar y planifi car sus acciones diarias, enfocándose en la seguridad del paciente. Descriptores: Atención de Enfermería; Gravedad del Paciente; Carga de Trabajo; Gestión de la Seguridad; Seguridad del Paciente. Severity and workload related to adverse events in the ICU Serafim CTR, et al. Severity and workload related to adverse events in the ICU

RESUMO:A gravidade do paciente ou o número de intervenções nem sempre serão proporcionais à carga de trabalho de enfermagem. Este estudo descritivo teve como objetivo demonstrar a trajetória da construção de um aplicativo (software) com o conteúdo do Nursing Activities Score e suas características operacionais. Foi realizado um teste piloto com 12 pacientes seguindo-se a coleta de dados por 90 dias consecutivos em 123 pacientes. Houve compatibilidade na transmissão de dados do Personal Digital Assistent para o computador de mesa, via wireless. A construção do aplicativo resultou em um sistema com coleta e administração de dados e permitiu realizar a interface gráfica. A utilização do aplicativo possibilita o uso de um sistema tecnológico para aplicação diária, com alimentação de um banco de dados sobre as características dos cuidados requeridos. Conhecendo a evolução destas variáveis durante a internação, o enfermeiro poderá planejar, intervir e avaliar a qualidade do cuidado. DESCRITORES:Enfermagem. Unidade de terapia intensiva. Informática. Carga de trabalho. Nursing activities score. COMPUTER APPLICATION WITH THE NURSING ACTIVITIES SCORE: AN INTENSIVE CARE MANAGEMENT INSTRUMENT ABSTRACT:Patients severity or the number of interventions will not always be proportional to the nursing staff's work load. This descriptive study aimed at demonstrating the trajectory for designing a computer application (software) with Nursing Activities Score content and its operational characteristics. A pilot test was conducted with 12 patients, which was followed by data collection from 123 patients for 90 consecutive days. Compatibility was observed in wireless data transmission from the Personal Digital Assistent to the desk computer. This application's construction resulted in a data collection and administration system, as well as enabled graphic interface. The use of the software allows for the utilization of a technological system with daily applications, with the support of a database concerning the characteristics of required care. With better understanding of the development of such variables during hospitalization, nurses will be able to plan, intervene, and evaluate care quality. DESCRIPTORS:Nursing. Intensive care unit. Informatics. Workload. Nursing activities score. APLICATIVO INFORMATIZADO CON EL NURSING ACTIVITIES SCORE: INSTRUMENTO PARA GESTIÓN DE LA ATENCIÓN EN LA UNIDAD DE CUIDADOS INTENSIVOSRESUMEN: La gravedad de la enfermedad del paciente o el número de intervenciones no son siempre proporcionales a la carga de trabajo de la enfermería. Este estudio descriptivo tuvo como objetivo demostrar la trayectoria de la construcción de un aplicativo (software) con el contenido del Nursing Activities Score y sus características operacionales. Se realizó un test piloto con 12 pacientes y se recolectaron los datos por 90 días consecutivos en 123 pacientes. Hubo compatibilidad en la transmisión de datos del Personal Digital Assistent para la computadora de mesa inalámbrica. La construcción del aplicativo resultó en un sis...

IAH was frequent in patients undergoing abdominal surgeries during ICU stay, and it predicted the occurrence of AKI. Serial assessments of IAP did not provided better discriminatory power than initial evaluation.

Objective: To compare the Nursing Activities Score (NAS) between the Assistance Sites in an Intensive Care Unit. Method:Descriptive, retrospective study, carried out in the Intensive Care Unit of a teaching hospital. The patients were organized in Assistance Sites according to their clinical characteristics and the nursing team's composition was organized in accordance with the Nursing Activities Score (NAS). The confidence interval was set at p < 0.05. Results: the majority were male surgical patients with a mean age of 56.8 years. The postoperative care Site presented the greatest patient turnover. The overall average NAS was 71.7%. There was a difference in the nursing workload between the different Assistance Sites. The shorter length of stay and the nonsurvivors contributed to increasing the workload in the ICU. Conclusion: Comparing the NAS in the differentSites made it possible to organize the work process of the nursing team according to each group, contributing to patient safety. Estudio descriptivo, retrospectivo, realizado en la Unidad de Cuidados Intensivos de un hospital escuela. Los pacientes fueron organizados en Sitios Asistenciales según sus características clínicas y el dimensionamiento de los profesionales de enfermería fue realizado según el NAS. Se consideró p < 0,05. Resultados: Predominaron pacientes del sexo masculino, quirúrgicos y con edad media de 56,8 años. El Sitio post-operatorio presentó mayor rotación de pacientes. El NAS medio global fue el 71,7%. Se verificó diferencia de la carga de trabajo de enfermería entre los diferentes Sitios Asistenciales. El menor tiempo de internación y los pacientes no sobrevivientes contribuyeron con el aumento de la carga de trabajo en la UCI. Conclusión: Fue posible organizar el proceso de trabajo del equipo de enfermería de acuerdo con cada grupo, contribuyendo con la seguridad del paciente. Keywords

Objective: To adapt the contents of the Nursing Activities Score (NAS) tool to assist patients with cancer. Method: Methodological research that according to the Delphi Technique is a method aiming at the validation of content through agreement of experts. Results: It took two rounds of opinion of experts, which added content contributions without modifying the structure and score of the original tool. The level of agreement ranged from 71 to 86%, and biological factors and assistance were more suggested: Monitoring and controls; Laboratory investigations; Support and care for family members and patients; Intravenous replacement; Renal support; Management activities. Conclusion: A high level of complexity of patients with cancer, and the demand for care and biopsychosocial-spiritual care was diagnosed. This tool will enable the measurement of the workload of the Oncology Nursing team, which can contribute to the staffing dimensioning.

Objective: to characterize the profile of patients who developed pressure injuries and to analyze the retrospective scores obtained in the application of the Braden Q Scale in pediatric intensive care. Method: retrospective cohort study with analysis of secondary data from 34 electronic medical records of patients admitted to pediatric intensive care. Results: from the analysis of the scores obtained with the application of the Braden Q Scale, six records of pressure injuries were identified; the average age was 8.1 years; 66.6% were male; average of 41 days of hospitalization; main diagnoses are related to diseases of the respiratory, cardiac and neurological systems; all used invasive mechanical ventilation support and had a fasting prescription and use of a nasogastric tube. Conclusion: the clinical profile is correlated with the male gender, the higher frequency of respiratory diseases requiring mechanical ventilation, the use of vasoactive, vasopressor and sedative drugs, and the tube as a route of dietary administration. All of them had high risk scores for developing pressure injuries.

Objective: To identify the severity and workload of nursing with adult patients seeking admission to an Intensive Care Unit (ICU). Methods:A cross-sectional study with a quantitative, exploratory and prospective approach was performed, developed in a hospital in the state of São Paulo. Demographic data on patients were collected, the Simplified Acute Physiology Score III (SAPS III) was applied to assess the severity of patients and the Nursing Activities Score (NAS) was used to evaluate nursing workload, between July and August 2014. Results: The overall mean score of the SAPS III was 30.52 ± 18.39 and that of the NAS was 58.18 ± 22.29. The group of patients admitted to the ICU showed higher severity and higher workload of nursing compared to non-admitted patients. Non-admitted patients had an NAS of 53.85. Conclusion: The nursing workload in patients who were not admitted to the ICU was also high. The evaluation of workload in other contexts where patients are seriously ill is important.The workload assessment in other contexts where severely ill patients are found is evident. resumen Objetivo: Identificar la gravedad y la carga de trabajo de enfermería requerida por pacientes adultos candidatos a una vacante en Unidad de Terapia Intensiva (UTI). Método: Estudio transversal, cuantitativo, exploratorio y prospectivo, realizado en un hospital del interior de São Paulo. La recolección de datos demográficos utilizó el Simplified Acute Physiology Score III (SAPS III), para evaluar la gravedad, y el Nursing Activities Score (NAS), para evaluar la carga de trabajo de enfermería, entre julio y agosto de 2014. Resultados: El promedio general de la puntuación SAPS III fue 30,52; el NAS, 58,18. Los pacientes admitidos en la UTI presentaron mayor gravedad y carga de trabajo en comparación con pacientes no admitidos (NAS promedio de 53,85). KeywordsConclusión: La carga de trabajo de enfermería en los pacientes que no son admitidos en la UTI también es alta. Se debe evaluar la carga de trabajo en otros contextos donde estén pacientes graves.

Objectives: To measure the nursing workload in the Burn Intensive Care Units and evaluate its association with clinical variables, length of stay, and outcome of hospitalization. Methods: Cross-sectional study carried out in a Brazilian public large hospital. The study included 33 patients. The nursing workload was assessed using the Nursing Activities Score (NAS) every 24 hours. We performed 447 Nursing Activities Score assessments. For the statistical analysis, Student’s t-test, ANOVA, and Spearman’s correlation test were used. The considered significant difference was 5% (p ≤ 0.05). Results: The Nursing Activities Score mean was 84% (± 4.4), which corresponded to 20.2 hours. There was an association between the nursing workload and the patient’s severity (p <0.010), burned body surface (p = 0.010), and hospitalization outcome (p = 0.020). Conclusion: Burn victims, assisted in the ICU, demanded a high nursing workload, which was influenced by clinical aspects and the hospitalization outcome. These findings point to the need to reconsider the nurse staffing related to this care profile.