Aging as a predictor of nursing workload in Intensive Care Unit: results from a Brazilian Sample

Abstract

OBJECTIVE Verify if aging is an independent predictor of NW in ICU, according to age groups, and its predictive value as a determinant of NW in ICU. METHODS Study was conducted from 2012 to 2016. A convenience sample composed by patients (age ≥ 18) admitted to nine ICU belonging to a Brazilian hospital, was analyzed. Age was assumed as an independent variable and NW (measured by the Nursing Activities Score - NAS) as dependent. Linear regression model and ROC curve were used for the analysis. RESULTS 890 participants (361 older people), mostly males (58.1%). The mean NAS score was higher among older participants in comparison to adults (p=0.004) but not within categories of aging (p=0.697). Age was responsible for 0.6% of NAS score. Each year of age increases NAS score in 0.081 points (p=0.015). However, age was not a good predictor of NAS score (AUC = 0.394; p=0.320). CONCLUSION The care of older people in ICU is associated with an increase in NW, compared to adults. Aging can be considered an associated factor but not a good predictor of NW in ICU.

Nursing Activities Score by assistance sites in Intensive Care Units

“…4,7,8,13,15 The mean age was 56.8 years old, and this is also consistent with other studies undertaken in Brazil. 4,7,16 and abroad 10,11,17 In relation to the outcome of survival or nonsurvival of the patients, it may be observed that 27.1% of the patients did not, ultimately, survive. In other studies undertaken in Brazilian ICUs, the mortality rate was 41.0% 2 and 21.6%, 4 while in studies undertaken in ICUs abroad, this value is close to 10.0%.…”

“…One study undertaken with the aim of relating NAS in two different age groups among patients over 18 years old in ICU found that the elderly patients (over 60 years old) have a higher nursing workload in comparison with the adult patients; however, age, as it represented a very low portion of the workload and in the NAS score, had no discrimination ability as a good independent predictor of high workload in ICU. 4 In relation to the NAS in each Assistential Site, it was verified that the highest mean NAS was found in the Postoperative Site in the month of September. This was where the patients requiring pre-and post-surgical care, from various surgical specialties, were treated.…”

“…4,7,16 and abroad 10,11,17 In relation to the outcome of survival or nonsurvival of the patients, it may be observed that 27.1% of the patients did not, ultimately, survive. In other studies undertaken in Brazilian ICUs, the mortality rate was 41.0% 2 and 21.6%, 4 while in studies undertaken in ICUs abroad, this value is close to 10.0%. 8,17 It may be considered that the non-survival rate, at close to 27.0%, found in the present study, may result from the association of different variables -such as preexistent chronic illnesses or the extensive length of stay in ICU, and the consequent Healthcare Associated Infections (HCAI).…”

“…Consequently, they also impact on the work process and on the team's workload. 3,4 Inadequate allocation of human resources is associated with the occurrence of adverse events, patient mortality, and increases in hospital costs. 5 In this regard, one important challenge for the managers of these complex units is the nursing team's adaptation to these patients' care demands.…”

The influence of delayed admission to intensive care unit on mortality and nursing workload: a cohort study

“…With regard to the predictive factors for the nursing workload required by patients in the first 24 h and during their stay in the ICU, it has been noted that age had an influence on these outcomes. A study that examined 890 patients also found that this variable had an effect on nursing workload during the patient's stay in the ICU, that is, for every additional year in a patient's age, the NAS increased by 0·081 points (Ferretti‐Rebustini et al, ). Other investigations have not detected any relationship between age and nursing workload, either at the time of admission (Gonçalves and Padilha, ) or during the stay of the patient in the ICU (Ciampone et al, ; Gonçalves et al, ).…”