Carga de trabalho de enfermagem em Unidade de Terapia Intensiva de um hospital de ensino

Panunto, Marcia Raquel; Guirardello, Edinêis de Brito

doi:10.1590/s0103-21002012000100017

Cited by 24 publications

(25 citation statements)

References 16 publications

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“…Results from this study confirmed that nursing activities are susceptible to the complexities of the patient’ diseases (Fagerström & Vainikainen, ; Panunto & Guirardello, ). In fact, in patients with hypertension the most frequently performed activity was providing information on urgent symptoms to be monitored and reported to the doctor and, to diabetic and COPD patients, providing information about medical devices useful to manage these diseases.…”

Section: Discussionsupporting

confidence: 73%

Discharge of older patients with chronic diseases: What nurses do and what they record. An observational study

Facchinetti

Ianni

Piredda

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To describe which nursing activities are observed during the discharge of older patients with chronic diseases and to investigate the consistency between the nursing activities actually observed and those documented. Background The discharge from hospital of older patients with chronic diseases is a critical transition that can lead to dissatisfaction, delays in discharge, re‐admission, adverse events and increased mortality. Although nurses’ interventions during discharge are important for patient outcomes, little is known about the nursing activities actually performed as compared with those documented. Design An observational study of the nursing activities performed during patients’ discharge and a retrospective audit of the nursing records of the same patients and nurses. Methods Structured nonparticipant observations were conducted of the activities performed by nurses at discharge. A retrospective audit of the nursing records relating to patient discharge, including the nursing diary and the assessment of critical issues at hospital discharge, was also conducted. The STROBE guidelines were followed (See Supporting Information Appendix S2). Results During hospital discharge of 102 patients, 1,224 nursing activities were observed. The number of activities was not related to patients’ age, gender and educational level, nor to nurses’ postgraduate education. Statistically significant correlations emerged between the number of activities observed and the nurses’ work experience. Conclusions A predefined discharge plan guiding nurses’ activities during discharge would enable them to respond better to the care needs of elderly patients. Relevance to clinical practice Results from the study could help clinical nurses to address care priorities of patients at discharge, by using appropriate plans and checklists and improving recording rates. Novice nurses should be supported when caring for elderly patients with chronic disease at discharge.

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Section: Discussionsupporting

confidence: 73%

Discharge of older patients with chronic diseases: What nurses do and what they record. An observational study

Facchinetti

Ianni

Piredda

et al. 2019

Journal of Clinical Nursing

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“…Os achados também corroboram pesquisas que avaliaram a carga de trabalho, ainda em UTI. 14,15 Esse cenário homogêneo revela-se, talvez, como um dado a ser considerado pelos gerentes de enfermagem de UTI na gestão do cuidado intensivo, seja no treinamento da equipe, na alocação de recursos e no mapeamento de fluxos de trabalho.…”

Section: Discussionunclassified

Sizing of the Nursing Staff in Adult Intensive Therapy

Souza

Inoue

Oliveira

et al. 2018

Reme Revista Mineira De Enfermagem

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RESUMOO objetivo consistiu em dimensionar o quadro de pessoal de enfermagem de uma unidade de terapia intensiva para adultos. Trata-se de pesquisa transversal, prospectiva, descritiva e quantitativa. Foi realizada na Unidade de Terapia Intensiva para Adultos (UTI-A) de um hospital universitário do Paraná, Brasil. A coleta de dados ocorreu entre junho e outubro de 2014 pela aplicação do Nursing Activities Score (NAS) a uma amostra (n=81) de prontuários de pacientes, obtendo a mensuração da carga de trabalho média (565,32 pontos) da equipe de enfermagem do setor. Com isso, dimensionou-se o quadro de pessoal da categoria, confrontando-o com a legislação nacional correspondente à Resolução nº 543/2017 do Conselho Federal de Enfermagem. O quadro dimensionado total da equipe foi de 32 trabalhadores, sendo 17 enfermeiros e 15 técnicos de enfermagem. À comparação com o quadro real, houve déficit geral de três profissionais. Faltavam oito enfermeiros assistenciais, evidenciando superávit de cinco trabalhadores de nível médio. Concluiu-se que o quadro de pessoal de enfermagem da UTI-A é subdimensionado, o que pode afetar a qualidade e a segurança do cuidado intensivo, além de comprometer a identidade profissional do enfermeiro.The objective of this work was to investigate the sizing of the nursing staff of an adult intensive care unit. This is a cross-sectional, prospective, descriptive and quantitative research carried out in the Adult Intensive Care Unit (ICU-A) of a university hospital in Paraná, Brazil. Data collection occurred between June and October 2014 through the application of the Nursing Activities Score (NAS) to a sample of medical records of patient (n=81), obtaining the measurement of the average workload (565.32 points) of the nursing team of the sector. As a result, the staff of the category was compared to the national legislation corresponding to Resolution nº 543/2017 of the Federal Council of Nursing. The total size of the staff was 32 workers, of whom 17 were nurses and 15 were nursing technicians. Compared to the real picture, there was an overall deficit of three professionals. Eight nurses were missing, evidencing a surplus of five middle-level workers. We concluded that the nursing staff of the ICU-A is undersized and this situation can affect the quality and safety of intensive care, as well as compromise the professional identity of nurses.

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“…Some studies in specialized ICUs describe NAS scores between 60% and 80% for cardiac ICU patients (11)(12)(13) , 62.9% for neurological patients (12) , 70.4% for burn patients (14) , and 71.3% in trauma patients (15) . In general Brazilian ICUs, the NAS data show values around 60.0% (15)(16)(17)(18) . Thus, studies that relate the nursing workload to the AKI patient, using the NAS in ICUs, can contribute to the promotion of quality nursing care, and support adequate professional staffing.…”

Section: Introductionmentioning

confidence: 98%

Nursing Activities Score and Acute Kidney Injury

et al. 2017

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Objective: to evaluate the nursing workload in intensive care patients with acute kidney injury (AKI). Method: A quantitative study, conducted in an intensive care unit, from April to August of 2015. The Nursing Activities Score (NAS) and Kidney Disease Improving Global Outcomes (KDIGO) were used to measure nursing workload and to classify the stage of AKI, respectively. Results: A total of 190 patients were included. Patients who developed AKI (44.2%) had higher NAS when compared to those without AKI (43.7% vs 40.7%), p <0.001. Patients with stage 1, 2 and 3 AKI showed higher NAS than those without AKI. A relationship was identifi ed between stage 2 and 3 with those without AKI (p = 0.002 and p <0.001). Conclusion: The NAS was associated with the presence of AKI, the score increased with the progression of the stages, and it was associated with AKI, stage 2 and 3. Descriptors: Workload; Intensive Care Unit; Acute Renal Injury; Nursing; Nephrology. RESUMO Objetivo: avaliar a carga de trabalho de enfermagem em pacientes de terapia intensiva com lesão renal aguda (LRA). Método: estudo quantitativo, em Unidade de Terapia Intensiva, no período de abril a agosto de 2015. O Nursing Activities Score (NAS) e o Kidney Disease Improving Global Outcomes (KDIGO) foram utilizados para medir a carga de trabalho de enfermagem e classifi car o estágio da LRA, respectivamente. Resultados: foram incluídos 190 pacientes. Os pacientes que desenvolveram LRA (44,2%) possuíam NAS superiores quando comparados aos sem LRA (43,7% vs 40,7%), p<0,001. Os pacientes com LRA nos estágios 1, 2 e 3 de LRA demonstraram NAS superiores aos sem LRA, houve relação entre os estágios 2 e 3 com os sem LRA, p=0,002 e p<0,001. Conclusão: o NAS apresentou associação com a existência de LRA, visto que seu valor aumenta com a progressão dos estágios, tendo associação com os estágios 2 e 3 de LRA. Descritores: Carga de Trabalho; Unidades de Terapia Intensiva; Lesão Renal Aguda; Enfermagem; Nefrologia. RESUMEN Objetivo: evaluar la carga de trabajo de enfermería en pacientes de cuidados intensivos con lesión renal aguda (AKI -acute kidney injury). Método: un estudio cuantitativo en la Unidad de Cuidados Intensivos en el período desde abril hasta agosto de 2015. El Nursing Activities Score (NAS) y el Kidney Disease Improving Global Outcomes (KDIGO) fueron utilizados para medir la carga de trabajo de enfermería y clasifi car el estadio de AKI, respectivamente. Resultados: en total, se incluyeron 190 pacientes. Los pacientes que desarrollaron AKI (44,2%) tenían NAS superior en comparación con los pacientes sin AKI (43,7% vs 40,7%), p<0,001. Los pacientes con AKI en los estadios 1, 2 y 3 de AKI mostraron NAS más alto que aquellos sin AKI. Hubo una relación entre los estadios 2 y 3 y los pacientes sin AKI, p=0,002 y p<0,001. Conclusión: NAS se asoció con la existencia de AKI porque su valor aumenta con la progresión de los estadios y tiene asociación con los estadios 2 y 3 de AKI.

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Carga de trabalho de enfermagem em Unidade de Terapia Intensiva de um hospital de ensino

Cited by 24 publications

References 16 publications

Discharge of older patients with chronic diseases: What nurses do and what they record. An observational study

Discharge of older patients with chronic diseases: What nurses do and what they record. An observational study

Sizing of the Nursing Staff in Adult Intensive Therapy

Nursing Activities Score and Acute Kidney Injury

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