Risk factors for increased in-hospital mortality: a cohort study among cardiac surgery patients

Objective:To assess the impact of promoting self-care in nursing workload and associate it to the variables: age, gender, socioeconomic status, education, marital status and number of children of caregivers. Methods: Prospective study with 31 children and their caregivers. Participants were assessed at two moments, 1 st and 2 nd hospitalization, the nursing workload was measured by the Nursing Activities Score (NAS). Results: The mean NAS in the 1 st hospitalization was 60.9% and in the 2 nd hospitalization was 41.6%, that is, 14.6 and 9.9 hours of nursing, respectively. The nursing workload on the first day of hospitalization was higher compared to the last day, both for the 1 st (p<0.001) and for the 2 nd hospitalization (p<0.001), and higher in the first (p<0.001) and in the last day (p=0.025) in the 1 st hospitalization. Comparing the 1 st hospitalization to the 2 nd hospitalization, the first was higher (p<0.001), and NAS items related to the training of self-care was influenced (p<0.001). Conclusion: The nursing workload associated to self-care promotion corresponded to 14.6 hours and was higher than determined by the existing legislation.

Section: Discussionmentioning

confidence: 99%

Impact of promoting self-care in nursing workload

Trettene

Fontes

Razera

et al. 2016

“…In Greek health care settings, exploration of nursing workload is also very limited (17)(18) . Furthermore, although a few studies have explored professional satisfaction among Greek hospital nurses (6,19) , these issues have not been addressed among Greek CCU nurses.…”

Section: Introductionmentioning

confidence: 99%

Measuring professional satisfaction and nursing workload among nursing staff at a Greek Coronary Care Unit

Gouzou

Karanikola

Lemonidou

et al. 2015

Objective To explore potential associations between nursing workload and professional satisfaction among nursing personnel (NP) in Greek Coronary Care Units (CCUs). Method A cross-sectional study was performed involving 66 members of the NP employed in 6 randomly selected Greek CCUs. Job satisfaction was assessed by the IWS and nursing workload by NAS, CNIS and TISS-28. Results The response rate was 77.6%. The reliability of the IWS was α=0.78 and the mean score 10.7 (±2.1, scale range: 0.5-39.7). The most highly valued component of satisfaction was “Pay”, followed by “Task requirements”, “Interaction”, “Professional status”, “Organizational policies” and “Autonomy”. NAS, CNIS and TISS-28 were negatively correlated (p≤0.04) with the following work components: “Autonomy”, “Professional status”, “Interaction” and “Task requirements”. Night shift work independently predicted the score of IWS. Conclusion The findings show low levels of job satisfaction, which are related with nursing workload and influenced by rotating shifts.

“…The NAS findings have indicated that sociodemographic (6)(7) and clinical variables, (7) length of stay in the ICU (11) , mortality (8) and severity of the patient's conditions (8,10,12) are factors associated with the high workload of the nursing staff. Studies conducted with patients in the postoperative period of cardiac surgery showed that, in the first 24 hours, the nursing workload ranged from 61.6% to 96.8% (10)(11)(12)(13) . In addition, the authors observed that, in this population, the NAS was associated with adverse outcomes such as increased length of stay in the ICU, complications and mortality (13)(14)(15) .…”

Section: Introductionmentioning

confidence: 99%

“…Studies conducted with patients in the postoperative period of cardiac surgery showed that, in the first 24 hours, the nursing workload ranged from 61.6% to 96.8% (10)(11)(12)(13) . In addition, the authors observed that, in this population, the NAS was associated with adverse outcomes such as increased length of stay in the ICU, complications and mortality (13)(14)(15) . The clinical complexity of the patient's condition, highly specific care in the postoperative period, the sophistication of the treatment regimen and daily use of circulatory and respiratory support technology are elements that can directly impact nursing workload.…”

Section: Introductionmentioning

confidence: 99%

Avaliação da carga de trabalho no pós-operatório de cirurgia cardíaca segundo o Nursing Activities Score

Oliveira

Rodrigues

Püschel

et al. 2015

RESUMO Objetivo Identificar os fatores associados à carga de trabalho de enfermagem no cuidado a pacientes no pós-operatório de cirurgia cardíaca. Método Estudo de coorte prospectivo, conduzido com 187 pacientes da Unidade de Terapia Intensiva Cirúrgica (UTI) do Instituto do Coração. Os dados foram coletados nas primeiras 24 e 72 horas do paciente na UTI. A variável dependente foi a carga de trabalho calculada por meio do Nursing Activities Score (NAS) e as independentes foram de natureza demográfico-clínicas e escores de morbimortalidade. Para análise dos dados utilizou-se os testes de Wilcoxon-Mann-Whitney e de correlação de Spearman, e a regressão linear com modelo de efeitos mistos. Resultados A maioria dos pacientes era do sexo masculino (59,4%), com média de idade de 61 anos (±12,7) e 43,9% desenvolveram algum tipo de complicação no pós-operatório. Nas 24 horas, a carga de trabalho foi de 82,4% (±3,4) e foi de 58,1% (±3,4) nas 72 horas. Os fatores associados ao aumento do NAS foram: tempo de internação do paciente na UTI (p=0,036) e a presença de complicações (p<0,001). Conclusão A gravidade do paciente nas 24 horas, em oposição a inúmeros estudos, não influenciou no aumento da carga de trabalho, a qual se mostrou associada ao tempo de internação e às complicações.