Use of scores to calculate the nursing workload in a pediatric intensive care unit

Abstract

ObjectiveTo assess the performance of the Nursing Activities Score in a pediatric intensive care unit, compare its scores expressed as time spent on nursing activities to the corresponding ones calculated using the Simplified Therapeutic Intervention Scoring System, and correlate the results obtained by both instruments with severity, morbidity and mortality.MethodsProspective, observational, and analytical cohort study conducted at a type III general pediatric intensive care unit. The study participants were all the children aged 29 days to 12 years admitted to the investigated pediatric intensive care unit from August 2008 to February 2009.ResultsA total of 545 patients were studied, which corresponded to 2,951 assessments. The average score of the Simplified Therapeutic Intervention Scoring System was 28.79±10.37 (915±330 minutes), and that of the Nursing Activities Score was 55.6±11.82 (802±161 minutes). The number of minutes that resulted from the conversion of the Simplified Therapeutic Intervention Scoring System score was higher compared to that resulting from the Nursing Activities Score for all the assessments (p<0.001). The correlation between the instruments was significant, direct, positive, and moderate (R=0.564).ConclusionsThe agreement between the investigated instruments was satisfactory, and both instruments also exhibited satisfactory discrimination of mortality; for that purpose, the best cutoff point was 16 nursing hours/patient day.

Measuring the nursing workload in intensive care with the Nursing Activities Score (NAS): A prospective study in 16 hospitals in Belgium

“…The PICU NAS results (morning: 60.4% and night: 58.4%) are substantially similar to other studies in pediatric intensive care units [53,55].…”

Nursing workload in specialized Semi-intensive Therapy unit: workforce size criteria

“…A research that sought to identify the NW in different nurseries belonging to a neonatal Unit, listed according to the severity of patients at low risk, medium risk, high risk and isolation, showed that the NAS mean was proportional to the complexity of care (11) . Another study with the same objective in a Pediatric ICU, found NAS mean greater than 56% (17) . Both allow inference that the greater the complexity, the greater the nursing workload.…”

Associação entre condições de trabalho da enfermagem e ocorrência de eventos adversos em Unidades Intensivas neopediátricas

“…The results reveal that the workload, obtained by NAS score, varied from 56 to 94%, which corresponds, respectively, to 13.38 and 22.53 hours of nursing assistance to the patient in a 24-hour period. Other studies conducted in Brazil point a mean pediatric ICU workload of 50% (18)(19) .…”