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Reguera-Carrasco C, Barrientos-Trigo S. Instruments to measure complexity of care based on nursing workload in intensive care units: A systematic review. Intensive Crit Care Nurs 2024:103672. [PMID: 38692967 DOI: 10.1016/j.iccn.2024.103672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/22/2024] [Accepted: 03/02/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVE To establish an evidence-based recommendation on the use of validated scoring systems that measure nursing workload in relation to the complexity of care in adult Intensive Care Units. METHODS A systematic review based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) was conducted (PROSPERO registration: CRD42021251272). We searched for validation studies until July 2023 using the bibliographic databases CINAHL, Scopus, Pubmed, WOS, Cochrane Database, SCIELO, Cuiden and Cuidatge. Reference selection and data extraction was performed by two independent reviewers. The assessment of risk of bias was performed using QUADAS-2 and the overall quality according to COSMIN and GRADE approach. RESULTS We included 22 articles identifying 10 different scoring systems. Reliability, criterion validity and hypothesis testing were the most frequently measurement properties reported. The NAS was the only tool to demonstrate a Class A recommendation (the best performing instrument). CONCLUSIONS NAS is the best currently available scoring system to assess complexity of care from nursing workload in ICU. However, it barely met the criteria for a class A recommendation. Future efforts should be made to develop, evaluate, and implement new systems based on innovative approaches such as intensity or complexity of care. IMPLICATIONS FOR CLINICAL PRACTICE The results facilitate decision making as it establishes a ranking of which instruments are recommended, promising or not recommended to measure the nursing workload in the intensive care units.
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Affiliation(s)
- Cristina Reguera-Carrasco
- Department of Nursing, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, C/ Avenzoar, 6, 41009 Seville, Spain.
| | - Sergio Barrientos-Trigo
- Department of Nursing, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, C/ Avenzoar, 6, 41009 Seville, Spain
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Cruz López LN, Quintero Osorio JF, Melo Roa JD, Henao Castaño ÁM. Carga laboral de profesionales de enfermería en Unidad de Cuidado Intensivo según Nursing Activities Score. REVISTA CUIDARTE 2023. [DOI: 10.15649/cuidarte.2680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
Highlights:
La NAS es una herramienta que toma relevancia al momento de evaluar la carga de trabajo de los profesionales de enfermería.
Se evidencia que el personal de enfermería está expuesto a altas cargas de trabajo que, en la mayoría de casos, supera lo sugerido por Consejos y Asociaciones de enfermería.
Algunos factores que pueden afectar la carga de trabajo son el tipo de turnos de trabajo, sexo del profesional, tipo de UCI, el número de pacientes a cargo, entre otros.
Es necesario evaluar la implementación de la NAS en distintos tipos de servicios para entender la situación y trabajo actual de los profesionales de enfermería.
Introducción: Nursing Activities Score ha sido utilizada como un instrumento principalmente en la Unidad de Cuidados Intensivos para medir las actividades de enfermería, siendo esta la unidad que maneja pacientes de mayor complejidad para el cuidado. Objetivo: establecer la carga de trabajo, evaluada por Nursing Activities Score, y factores relacionados a la misma en Unidades de Cuidado Intensivo. Metodología: Revisión cualitativa tipo scoping Review, utilizando el método PRISMA. Búsqueda en las bases de datos CINAHL, LILACS, SCOPUS, SCIENCE DIRECT, SCIELO y PUBMED. Resultados: La muestra final se compone de 87 textos, que van desde el año 2007 hasta 2021. Se clasificaron en cinco categorías: Carga de trabajo en UCI, comparación entre unidades, carga de trabajo relacionada al personal de enfermería, carga de trabajo relacionada a las características de los pacientes y consecuencias de la carga de trabajo. Discusión: La revisión revela una carga de trabajo mayor al 50% en la mayoría de los estudios, esto debido a diferentes factores: principalmente las características particulares de los pacientes, no se observó una diferencia significativa entre unidades generales y especializadas, las cargas de trabajo elevadas suponen un factor de riesgo para la ocurrencia de eventos adversos. Conclusiones: Los resultados de esta revisión permiten evidenciar que el personal de enfermería está expuesto constantemente a altas cargas de trabajo. Esta carga de trabajo puede verse influenciada o influenciar diversos factores, como lo son las características de los pacientes a quienes se brinda atención o puede afectar positiva o negativamente la calidad de la atención de enfermería.
Como citar este artículo: Cruz López Laura Nathalie, Quintero Osorio Jenny Fernanda, Melo Roa Juan David, Henao Castaño Ángela María. Carga laboral de profesionales de enfermería en Unidad de Cuidado Intensivo según Nursing Activities Score. Revista Cuidarte. 2023;14(1):e2680. http://dx.doi.org/10.15649/cuidarte.2680
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San José Arribas A, Santana-Padilla Y. La formación de las enfermeras en cuidados intensivos: indispensable para el paciente crítico. ENFERMERÍA INTENSIVA 2022. [DOI: 10.1016/j.enfi.2021.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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San José Arribas A, Santana-Padilla YG. Training of nurses in intensive care: essential for the critical patient. ENFERMERIA INTENSIVA 2022; 33:1-3. [PMID: 35131211 DOI: 10.1016/j.enfie.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 10/28/2021] [Indexed: 06/14/2023]
Affiliation(s)
- A San José Arribas
- Escola Universitari Sant Pau, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Y G Santana-Padilla
- Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, Spain.
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Huang SL, Cheng H, Duffield C, Denney-Wilson E. The relationship between patient obesity and nursing workload: An integrative review. J Clin Nurs 2021; 30:1810-1825. [PMID: 33529423 DOI: 10.1111/jocn.15679] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/03/2020] [Accepted: 01/22/2021] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To explore the relationship between patient obesity and nursing workload, and discuss the nursing activities most affected by patient obesity. BACKGROUND The increasing number of patients with obesity, and the severity of obesity, impacts the healthcare workforce, particularly to nurses who provide most direct care to patients. There is growing evidence to suggest that patient obesity may increase nursing workload and time taken for clinical care. DESIGN Integrative review. METHODS A comprehensive search of academic databases for primary research related to patient obesity and nursing workload, published since 2000, was conducted. References of relevant articles were hand-searched. RESULTS 27 articles were analysed. Analysis was undertaken at the levels of patient characteristics, nursing work and the healthcare system. The increasing number of patients with obesity, and the severity of patient obesity, increases nursing workload by affecting nursing time needed to deliver care. An increased number of nurses, particularly with increased clinical skill, are needed to deliver care meeting these increased needs. Organisational change is required to provide infrastructure and bariatric equipment that enables effective nursing care of patients with obesity. Organisations must consider additional time and staff needs when delivering care for patients with obesity. CONCLUSIONS The current health system is not established to address the challenge of providing nursing care to the increasing numbers of patients with obesity. Further research on accurately and objectively quantifying the impact and severity of patient obesity on nursing clinical activities is required. RELEVANCE TO CLINICAL PRACTICE When determining staffing, healthcare organisations must consider the increased nursing staff, time and clinical skill required to provide care for patients with obesity. Healthcare organisations should implement policies that ensure sufficient staffing in areas where care of patients with obesity is prevalent, and provide training for and workplace availability of bariatric equipment.
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Affiliation(s)
- Sizhao L Huang
- Gastroenterology and Neurology, Westmead Hospital, Westmead, Australia.,Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, Australia
| | - Heilok Cheng
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, Australia
| | - Christine Duffield
- School of Nursing and Midwifery, University of Technology Sydney, Ultimo, Australia.,School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia
| | - Elizabeth Denney-Wilson
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, Australia.,Sydney Local Health District, NSW Health, Sydney, Australia
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Rengeiné TK, Tihanyi E, Dinya E, Smudla A, Kóbori L, Kanizsai P, Fazakas J. Mapping nursing interventions using the Therapeutic Intervention Scoring System in bloodless liver transplantations. Intensive Crit Care Nurs 2020; 61:102917. [PMID: 32855007 DOI: 10.1016/j.iccn.2020.102917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/21/2020] [Accepted: 07/01/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND The Simplified Therapeutic Intervention Scoring System adapted to liver transplantation by King's College Hospital rank 138 activities to determine the nursing workload, diagnostic, monitoring and therapeutic needs. OBJECTIVES To evaluate nursing activities of "King's-TISS" score grouped in organ systems and nurse patient ratio in the perioperative 48 hours of blood product free liver transplantations (LT). METHODS The "King's-TISS" score's were analysed by nursing procedures and grouped, scored according to organ systems. The nursing workloads were studied during LT (T1), on arrival on the ICU (T2) and 12-24-48 hours after LT (T3-T4-T5). RESULTS The total of "King's-TISS" score points were decreased by ≥20% daily (p = 0.001). The mean score of 104 ± 3.5 points (CI:104-105) during LT decreased to 84.7 ± 12 points (CI:83-86) in 48 hours (T5). The "metabolic" and "haemostasis" points increased (p = ).01), the "immunology" points unchanged (T2-T5) postoperatively. A slight decrease was observed in case of "basic nursing care", "monitoring", "neurologic support", "renal support" and "cardiovascular support" points (T2-T5, p < .01). The "invasive intervention" and "ventilatory support" points strongly decreased (T2-T5, p < .001). One "King's-TISS" point was found to equal 7.4 minutes with a nurse patient ratio of 2:1 intraoperatively and 1:1 postoperatively. CONCLUSION Absence of blood product administration in LT decreases the total and organ specific workload, except the metabolic, haemostasis, immunology and basic support requirement. It was not within the scope of the King's-TISS score to analyse the application of viscoelastic haemostasis test and coagulation factor concentrate administration.
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Affiliation(s)
- T K Rengeiné
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary.
| | - E Tihanyi
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - E Dinya
- Semmmelweis University, Institute of Digital Health Sciences, Budapest, Hungary.
| | - A Smudla
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - L Kóbori
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - P Kanizsai
- University of Pécs, Clinical Centre, University Department of Emergency Medicine, Pécs, Hungary; Semmelweis University, Faculty of Medicine, Department of Anesthesiology and Intensive Therapy, Hungary.
| | - J Fazakas
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
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Khalooeifard R, Djafarian K, Safabakhsh M, Rahmani J, Shab-Bidar S. Dose-Response Meta-Analysis of the Impact of Body Mass Index on Mortality in the Intensive Care Unit. Nutr Clin Pract 2020; 35:1010-1020. [PMID: 32181950 DOI: 10.1002/ncp.10473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Both low and high body mass index (BMI) are associated with mortality in the intensive care unit (ICU). Although many studies have been done to determine the relationship between BMI and risk of mortality in the ICU, their results were inconsistent. This study aimed to conduct a dose-response meta-analysis of published observational studies to assess the effect of BMI on the risk of mortality in patients admitted to the ICU. METHODS PubMed, Scopus, and Google Scholar were searched to identify articles up to May 2019. A total of 31 relevant articles, with 238,961 patients and a follow-up period of 1 month to 11 years, were analyzed. RESULTS Linear analysis showed a 0.6% decrease in mortality rate per unit (kg/m2 ) increase in BMI (odds ratio: 0.99; 95% CI, 0.98-0.99). In addition, nonlinear analysis showed a decrease in risk of mortality for a BMI of 35 (P < .001) and then increased the risk of mortality with a BMI > 35 (P < .001). CONCLUSION This dose-response meta-analysis revealed that a BMI ≤ 35 can be a protective agent against mortality, but a BMI > 35 is a life-threatening factor in patients admitted to the ICU.
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Affiliation(s)
- Razieh Khalooeifard
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kurosh Djafarian
- Department of Clinical, Nutrition, School of Nutritional Sciences and Dietetics and School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Safabakhsh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Jamal Rahmani
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Yim GH, Singh Pujji OJ, Singh Bharj I, Farrar E, Steven LA J. The value of a bariatric specific chart to initiate resuscitation of adult bariatric burns. Burns 2019; 45:1783-1791. [PMID: 31585680 DOI: 10.1016/j.burns.2019.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 01/29/2019] [Accepted: 04/08/2019] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The prevalence of obese adults is rising across the world with a tripling of rates since 1975. The resuscitation of large burns in obese patients brings unique challenges leading some to advocate the use of a bariatric specific burn chart. AIMS We sought to determine whether bariatric burn specific charts can better estimate burn percentage to prevent under resuscitation. We also reviewed the impact of obesity upon the length of hospital stay, morbidity and mortality at our institution. METHODS A retrospective case note review, of patients identified from the prospective International Burns Injury Database (iBID), was undertaken of patients' ≥18 years of age with burns ≥15% of their total body surface area. RESULTS There were 79 overweight and 53 bariatric patients from a total of 232 patients identified. There was no statistical difference in burn percentage or fluid input estimation between the Lund & Browder and Neaman charts. Complications were seen in 51% of the normal weight patients. Obese patients had a similar incidence of death (24%) compared to the normal weight group (26%). The class I obese had the lowest complication rate at 28% and lowest mortality rate at 11%. CONCLUSIONS Bariatric specific charts did not demonstrate any benefits in optimising bariatric resuscitation. There appears to be a 'physiological benefit' in the class I obese who sustained burns undergoing resuscitation.
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Affiliation(s)
- Guang Hua Yim
- Birmingham Burn Centre, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2WB, United Kingdom.
| | - Ojas Jyoti Singh Pujji
- Birmingham Burn Centre, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2WB, United Kingdom.
| | - Indervir Singh Bharj
- Birmingham Burn Centre, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2WB, United Kingdom.
| | - Edmund Farrar
- Birmingham Burn Centre, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2WB, United Kingdom.
| | - Jeffery Steven LA
- Birmingham Burn Centre, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2WB, United Kingdom; School of Health Sciences, Birmingham City University, Seacole Building, City South Campus, Westbourne Road, Birmingham B15 3TN, United Kingdom; School of Medicine, Cardiff University, University Hospital of Wales Main Building, Heath Park, Cardiff CF14 4XN, United Kingdom.
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Yu HY, Ahn EK, Seo EJ. Relationship between the frequency of nursing activities and adverse outcomes in patients with acute coronary syndrome: A retrospective cohort study. Nurs Health Sci 2019; 21:531-537. [PMID: 31523893 DOI: 10.1111/nhs.12645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 07/22/2019] [Accepted: 08/06/2019] [Indexed: 11/28/2022]
Abstract
The aim of this retrospective cohort study was to identify the relationship between the frequency of nursing activities during the first hospitalization and adverse outcomes in patients with acute coronary syndrome by using electronic health records. Patients diagnosed with acute coronary syndrome from April 2010 to April 2015 were examined for eligibility based on 36 months of major adverse cardiac events as the main outcome. Among the 652 patients who were enrolled, 66 patients experienced major adverse cardiac events. The average frequency of nursing activities was 1098.7 (±2703.8), and four variables (length of hospital stay, albumin level, hemoglobin level, and frequency of nursing activities) were significantly associated with 36 months of major adverse cardiac events. After adjusting for these variables, the frequency of nursing activities was found to be the only significant factor associated with the incidence of 36 months of major adverse cardiac events. This finding suggests that patients with acute coronary syndrome who require more frequent nursing activities during the first hospitalization could be vulnerable to adverse outcomes and should be closely monitored.
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Affiliation(s)
- Hye Yon Yu
- Department of Nursing, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Eun Kyoung Ahn
- Department of Nursing Science, Dongyang University, Yeongju, Korea
| | - Eun Ji Seo
- College of Nursing and Research Institute of Nursing Science, Ajou University, Suwon, Korea
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Lucchini A, De Felippis C, Elli S, Bambi S. The burden of not-weighted factors in nursing workload: Can Nursing Activities Score be more suitable than TISS 28 and NEMS? Intensive Crit Care Nurs 2019; 51:82-83. [DOI: 10.1016/j.iccn.2018.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 11/12/2018] [Indexed: 11/16/2022]
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Robstad N, Siebler F, Söderhamn U, Westergren T, Fegran L. Design and psychometric testing of instruments to measure qualified intensive care nurses' attitudes toward obese intensive care patients. Res Nurs Health 2018; 41:525-534. [PMID: 30302768 DOI: 10.1002/nur.21914] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 09/16/2018] [Indexed: 11/11/2022]
Abstract
The purpose of this pilot study was to design and test research instruments to measure qualified intensive care nurses' implicit and explicit attitudes and behavioral intentions toward obese intensive care patients. In previous studies researchers have demonstrated that some health professionals hold negative attitudes toward obese patients; however, little is known about qualified intensive care nurses' attitudes toward these patients. Our cross-sectional pilot study involved Implicit Association Tests, the Anti-fat Attitude questionnaire, an explicit bias scale comprising ratings of explicit beliefs and feelings, assessment of behavioral intentions based on vignettes, and demographic questions. Thirty qualified intensive care nurses from a general intensive care unit in Norway (80% female; age range 31-62 years) completed the study. Nurses reported implicit and explicit preferences for thin over thick patients and found obese patients lazier than normal-weight patients. Measures of behavioral intentions and anti-fat attitudes were reliable. Generally, the nurses intended to help obese patients immediately. Nevertheless, explicit anti-fat attitudes (rho = -0.49) as well as implicit anti-obese stereotypes (rho = -0.40) were negatively correlated with such intentions. Data supported satisfactory face validity, and convergent and discriminant validity within and between implicit and explicit attitudes and stereotypes. The set of research instruments were reliable, valid, and suitable tools to measure qualified intensive care nurses' implicit and explicit attitudes; however, the present findings need to be replicated in a larger-scale study.
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Affiliation(s)
- Nastasja Robstad
- Faculty of Health and Sport Sciences, Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Frank Siebler
- Faculty of Health Sciences, Department of Psychology, University of Tromsø, Langnes, Tromsø, Norway
| | - Ulrika Söderhamn
- Faculty of Health and Sport Sciences, Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Thomas Westergren
- Faculty of Health and Sport Sciences, Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Liv Fegran
- Faculty of Health and Sport Sciences, Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
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da Palma Afonso E. Nursing workload in the intensive care unit - Can it be measured? Intensive Crit Care Nurs 2018; 48:1-2. [PMID: 30033215 DOI: 10.1016/j.iccn.2018.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Elsa da Palma Afonso
- Neonatal Intensive Care Unit, Rosie Hospital, Cambridge University Hospitals, Cambridge, UK; Department of Internal Medicine, Ghent University, Ghent, Belgium.
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Nieri AS, Manousaki K, Kalafati M, Padilha KG, Stafseth SK, Katsoulas T, Matziou V, Giannakopoulou M. Validation of the nursing workload scoring systems "Nursing Activities Score" (NAS), and "Therapeutic Intervention Scoring System for Critically Ill Children" (TISS-C) in a Greek Paediatric Intensive Care Unit. Intensive Crit Care Nurs 2018; 48:3-9. [PMID: 29655596 DOI: 10.1016/j.iccn.2018.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 03/19/2018] [Accepted: 03/25/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To assess the reliability and validity of the Greek version of Nursing Activities Score (NAS), and Therapeutic Intervention Scoring System for Critically Ill Children (TISS-C) in a Greek Paediatric Intensive Care Unit (PICU). RESEARCH METHODOLOGY A methodological study was performed in one PICU of the largest Paediatric Hospital in Athens-Greece. The culturally adapted and validated Greek NAS version, enriched according to the Norwegian paediatric one (P-NAS), was used. TISS-C and Norwegian paediatric interventions were translated to Greek language and backwards. Therapeutic Intervention Scoring System (TISS-28) was used as a gold standard. Two independent observers simultaneously recorded 30 daily P-NAS and TISS-C records. Totally, 188 daily P-NAS, TISS-C and TISS-28 reports in a sample of 29 patients have been obtained during five weeks. Descriptive statistics, reliability and validity measures were applied using SPSS (ver 22.0) (p ≤ 0.05). RESULTS Kappa was 0.963 for P-NAS and 0.9895 for TISS-C (p < 0.001) and Intraclass Correlation Coefficient for all scale items of TISS-C was 1.00 (p < 0.001). P-NAS, TISS-28 and TISS-C measurements were significantly correlated (0.680 ≤ rho ≤ 0.743, p < 0.001). The mean score(±SD) for TISS-28, P-NAS and TISS-C was 23.05(±5.72), 58.14(±13.98) and 20.21(±9.66) respectively. CONCLUSION These results support the validity of P-NAS and TISS-C scales to be used in greek PICUs.
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Affiliation(s)
- Alexandra-Stavroula Nieri
- Department of Nursing, National and Kapodistrian University of Athens, 123 Papadiamantopoulou str., Goudi, 11527 Athens, Greece
| | - Kalliopi Manousaki
- Department of Nursing, National and Kapodistrian University of Athens, 123 Papadiamantopoulou str., Goudi, 11527 Athens, Greece
| | - Maria Kalafati
- Department of Nursing, National and Kapodistrian University of Athens, 123 Papadiamantopoulou str., Goudi, 11527 Athens, Greece
| | - Katia Grilio Padilha
- University of São Paulo, School of Nursing, Medical-Surgical Nursing Department, São Paulo, Brazil.
| | - Siv K Stafseth
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
| | - Theodoros Katsoulas
- Department of Nursing, National and Kapodistrian University of Athens, Greece; University ICU, Ag. Anargiroi General Hospital, Kaliftaki 41, 14564 Kifissia, Greece.
| | - Vasiliki Matziou
- Department of Nursing, National and Kapodistrian University of Athens, 123 Papadiamantopoulou str., Goudi, 11527 Athens, Greece.
| | - Margarita Giannakopoulou
- Department of Nursing, National and Kapodistrian University of Athens, 123 Papadiamantopoulou str., Goudi, 11527 Athens, Greece.
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Giuliani E, Lionte G, Ferri P, Barbieri A. The burden of not-weighted factors - Nursing workload in a medical Intensive Care Unit. Intensive Crit Care Nurs 2018; 47:98-101. [PMID: 29622474 DOI: 10.1016/j.iccn.2018.02.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 02/21/2018] [Accepted: 02/26/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Body weight and infection status affect nursing workload and are not accounted for in the Therapeutic Intervention Scoring System 28 (TISS-28) and Nine Equivalents of Nursing Manpower Use Score (NEMS). The objective of this study was to analyse the correlation between weight and infection status with TISS 28 and NEMS in a cohort of medical Intensive Care Unit patients. RESEARCH METHODOLOGY A retrospective observational trial was conducted on the nursing records of 26 randomly selected patients over a 12-month period. TISS-28 and NEMS were calculated for each day of ICU stay. Infectious status was determined based on positive cultures to multi-resistant organisms while overweight and obesity were based on Body Mass Index. RESULTS A total of 809 nursing shifts' activity records were analysed. There were 12 infected patients that required isolation, 14 overweight patients and 3 obese: 9 patients presented both conditions. Only the presence of both conditions was statistically associated with an increase in workload (TISS-28p-value = 0.041 and NEMS p-value = 0.011). CONCLUSIONS Although TISS-28 and NEMS do not specifically consider body weight and infection status, their integration into nursing workload scores may improve the accuracy as management tools, increasing the quality of the cares provided.
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Affiliation(s)
- Enrico Giuliani
- Anesthesia and Intensive Care, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanni Lionte
- Intensive Care, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Paola Ferri
- Nursing School, University of Modena and Reggio Emilia, Modena, Italy
| | - Alberto Barbieri
- Anesthesia and Intensive Care, University of Modena and Reggio Emilia, Modena, Italy.
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Pompilio CE, Pelosi P, Castro MG. The Bariatric Patient in the Intensive Care Unit: Pitfalls and Management. Curr Atheroscler Rep 2016; 18:55. [DOI: 10.1007/s11883-016-0606-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Bein T. [The dark side of obesity]. Anaesthesist 2016; 65:653-4. [PMID: 27447937 DOI: 10.1007/s00101-016-0204-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- T Bein
- Klinik für Anästhesiologie, Universitätsklinikum Regensburg, 93042, Regensburg, Deutschland.
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