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Manthou P, Lioliousis G, Pietri I, Vasileiou P, Dainavas D, Fildisis G. Nursing Workload in Patients With Myocardial Ischemia After Non-cardiac Surgery. Cureus 2022; 14:e30737. [PMID: 36457624 PMCID: PMC9705073 DOI: 10.7759/cureus.30737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2022] [Indexed: 06/17/2023] Open
Abstract
INTRODUCTION Nursing workload (NWL) in the intensive care unit (ICU) is an essential parameter of patient safety. However, little attention has been dedicated to measuring NWL in ICU about patients surgically treated with myocardial ischemia (MI). Methods: The objectives of this study are to describe and examine the NWL by applying the Nursing Activities Score in patients who underwent non-cardiac surgery and developed MI in the ICU. The statistical significance was set at 0.05. The statistical program SPSS 22.0 was used for the analysis. RESULTS The mean age was 69.1 years, whereas 32.4% of the patients had MI. Hypertension, diabetes mellitus, and dyslipidemia were the main comorbidities. On the first day in ICU, the NWL was similar in all patients (p = 0.947). In the following days, the NWL was significantly higher in patients with MI (p < 0.001). The NWL was considerably higher in patients with MI who died. CONCLUSIONS The present results are essential for planning and using nursing resources according to the care needs of postoperative patients with MI.
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Affiliation(s)
- Panagiota Manthou
- Nursing, National and Kapodistrian University of Athens, Athens, GRC
| | - Georgios Lioliousis
- Intensive Care Unit, First Department of Respiratory Medicine, Thoracic Diseases General Hospital Sotiria, National and Kapodistrian University of Athens, Athens, GRC
| | | | - Panagiotis Vasileiou
- Laboratory of Histology & Embryology, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
- Emergency Department, Thoracic Diseases General Hospital Sotiria, National and Kapodistrian University of Athens, Athens, GRC
| | - Dimitris Dainavas
- Intensive Care Unit, General Oncology Hospital of Kifisia, Athens, GRC
| | - Georgios Fildisis
- Nursing School, National and Kapodistrian University of Athens, Athens, GRC
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Batassini É, Silveira JTD, Cardoso PC, Castro DE, Hochegger T, Vieira DFVB, Azzolin KDO. Nursing Activities Score: qual periodicidade ideal para avaliação da carga de trabalho? ACTA PAUL ENFERM 2019. [DOI: 10.1590/1982-0194201900023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo: Comparar a carga de trabalho obtida a partir do Nursing Activities Score (NAS) pontuado três vezes ao dia, no final de cada turno de trabalho, e pontuado uma vez ao dia considerando as 24 horas. Métodos: Estudo longitudinal prospectivo, realizado com adultos internados em um Centro de Terapia Intensiva de um hospital público de alta complexidade do sul do Brasil. A coleta de dados foi realizada através do sistema Epimed Monitor®. No primeiro período do estudo (Período 1) a pontuação média do NAS foi obtida a partir de três avaliações diárias e no segundo período (Período 2) o NAS foi pontuado uma vez ao dia. A comparação das variáveis foi verificada por meio dos testes t-Studente Mann Whitney U. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da instituição de origem. Resultados: Durante o estudo foram realizadas 1738 avaliações de NAS em 338 pacientes. A média de pontuação do NAS foi de 74±20,9% para o total de pacientes. Não houve diferença entre a média do Período 1 (74,1±20,8%) e a média do Período 2 (73,9±21%) (p= 0,806). O Período 2 teve mais avaliações na categoria de NAS <50% e menos avaliações na categoria de NAS 50,1-100% em relação ao Período 1 (p<0,001 e p= 0,029, respectivamente). Conclusão: A pontuação média do NAS é semelhante quando comparada a aferição realizada três vezes ao dia com a realizada uma vez ao dia considerando as 24 horas anteriores para avaliação de carga de trabalho de enfermagem.
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Camuci MB, Martins JT, Cardeli AAM, Robazzi MLDCC. Nursing Activities Score: nursing work load in a burns Intensive Care Unit. Rev Lat Am Enfermagem 2016; 22:325-31. [PMID: 26107842 PMCID: PMC4292592 DOI: 10.1590/0104-1169.3193.2419] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Accepted: 09/30/2013] [Indexed: 12/04/2022] Open
Abstract
Objective to evaluate the nursing work load in a Burns Intensive Care Unit according
to the Nursing Activities Score. Method an exploratory, descriptive cross-sectional study with a quantitative
approach. The Nursing Activities Score was used for data collection between
October 2011 and May 2012, totalling 1,221 measurements, obtained from 50
patients' hospital records. Data for qualitative variables was described in
tables; for the quantitative variables, calculations using statistical
measurements were used. Results the mean score for the Nursing Activities Score was 70.4% and the median was
70.3%, corresponding to the percentage of the time spent on direct care to
the patient in 24 hours. Conclusion the Nursing Activities Score provided information which involves the process
of caring for patients hospitalized in a Burns Intensive Care Unit, and
indicated that there is a high work load for the nursing team of the sector
studied.
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Macedo APMDC, Mendes CMFS, Candeias ALS, Sousa MPR, Hoffmeister LV, Lage MIGS. Validação do Nursing Activities Score em unidades de cuidados intensivos portuguesas. Rev Bras Enferm 2016; 69:881-887. [DOI: 10.1590/0034-7167-2016-0147] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 06/15/2016] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: descrever o processo de adaptação e validação do Nursing Activities Score para o contexto português. Método: trata-se de um estudo-piloto de adaptação e validação do Nursing Activities Score, com amostra de 67 doentes internados em unidades de cuidados intensivos de três hospitais portugueses. A validade de constructo avaliou-se mediante procedimentos de análise fatorial e a consistência interna dos itens através do coeficiente Alpha de Cronbach. Resultados: obteve-se um valor médio da carga de trabalho de 63,04% (DP = 14,25; Mediana = 61,30). Os dados psicométricos revelaram um Alpha de Cronbach de 0,71, na escala total, indicando uma fidelidade aceitável. A análise fatorial confirmatória sugeriu um ajustamento adequado entre o modelo e os dados (χ2(199) = 214,5, p = 0,214; CFI = 0,95; RMSA = 0,035). Conclusão: neste estudo, a versão portuguesa do Nursing Activities Score revelou-se um instrumento válido, permitindo avaliar a carga de trabalho dos enfermeiros com segurança.
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Lachance J, Douville F, Dallaire C, Padilha KG, Gallani MC. The use of the Nursing Activities Score in clinical settings: an integrative review. Rev Esc Enferm USP 2015; 49 Spec No:147-56. [PMID: 26761705 DOI: 10.1590/s0080-623420150000700021] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 07/14/2015] [Indexed: 11/22/2022] Open
Abstract
Objective analyze how studies have approached the results obtained from the application of the Nursing Activities Score (NAS) based on Donabedian's model of healthcare organization and delivery. Method CINAHL and PubMed databases were searched for papers published between 2003 and March 2015. Results 36 articles that met the inclusion criteria were reviewed and double-coded by three independent coders and analyzed based on the three elements of Donabedian's health care quality framework: structure, process and outcome. The most frequently addressed, but not always tested, variables were those that fell into the structure category. Conclusion variables that fell into the process category were used less frequently. Beside NAS, the most frequently used variables in the outcome category were mortality and length of stay. However, no study used a quality framework for healthcare or NAS to evaluate costs, and it is recommended that further research should explore this approach.
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Affiliation(s)
- Joanie Lachance
- Faculté des Sciences Infirmières, Université Laval, Quebec, Canada
| | | | | | - Katia Grillo Padilha
- Departamento de Enfermagem Médico-Cirúrgica, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil
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Campagner AOM, Garcia PCR, Piva JP. [Use of scores to calculate the nursing workload in a pediatric intensive care unit]. Rev Bras Ter Intensiva 2015; 26:36-43. [PMID: 24770687 PMCID: PMC4031889 DOI: 10.5935/0103-507x.20140006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 01/14/2014] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To 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. METHODS Prospective, 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. RESULTS A 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). CONCLUSIONS The 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.
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Valls-Matarín J, Salamero-Amorós M, Roldán-Gil C. [Analysis of the workload and the use of the nursing resources in an intensive care unit]. ENFERMERIA INTENSIVA 2015; 26:72-81. [PMID: 25882964 DOI: 10.1016/j.enfi.2015.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 01/30/2015] [Accepted: 02/21/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To evaluate and assess the nursing workload (NW) scales by means of three scales and to determine the theoretical and real nurse/patient relationship in a polyvalent ICU. METHODOLOGY Cross-sectional descriptive study between July 2012 and June 2013 in patients over 18 years old, for which 3 nurses quantified, in randomized days, the NW by the Nursing Activities Score (NAS), Nine Equivalents Manpower Score (NEMS) and Valoración de Cargas de Trabajo y Tiempos de Enfermería (VACTE). Efficiency parameters of nursing resources were calculated: "work utilization ratio" (WUR), "level of care" operative (LOCop) and planned (LOCp). Data on demographics, length of stay and number of nurses were collected. RESULTS 720 records were collected. The mean age was 64 (13.6) years. 73% were male and the median of length of stay was 3 (1-12) days. 60% were admitted for medical causes. The average total score was: NAS: 696.8 (111.6), NEMS: 311.8 (55.3) and VACTE: 4,978 (897.7). The required number of nurses according to NAS was 7 and 6,7 according to NEMS and VACTE. The actual average was 5.5. On all 3 scales the WUR was >1 and LOCop was 1.6 pacients/nurse. The LOCp was 2 patients/nurse. CONCLUSION Assessing NW allows to know the reality of each unit. According to the scales and efficiency parameters of the nursing resources used, there is a shortage of nurses in relation to the work generated. NAS reflects more parameters of NW.
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Affiliation(s)
- J Valls-Matarín
- Unidad de Cuidados Intensivos, Hospital Universitario Mútua Terrassa, Terrassa, Barcelona, España.
| | - M Salamero-Amorós
- Unidad de Cuidados Intensivos, Hospital Universitario Mútua Terrassa, Terrassa, Barcelona, España
| | - C Roldán-Gil
- Unidad de Cuidados Intensivos, Hospital Universitario Mútua Terrassa, Terrassa, Barcelona, España
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Nogueira LDS, Koike KM, Sardinha DS, Padilha KG, de Sousa RMC. Nursing workload in public and private intensive care units. Rev Bras Ter Intensiva 2015; 25:225-32. [PMID: 24213086 PMCID: PMC4031844 DOI: 10.5935/0103-507x.20130039] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 08/20/2013] [Indexed: 12/05/2022] Open
Abstract
Objective This study sought to compare patients at public and private intensive care units
according to the nursing workload and interventions provided. Methods This retrospective, comparative cohort study included 600 patients admitted to 4
intensive care units in São Paulo. The nursing workload and interventions were
assessed using the Nursing Activities Score during the first and last 24 hours of
the patient's stay at the intensive care unit. Pearson's chi-square test, Fisher's
exact test, the Mann-Whitney test, and Student's t test were used to compare the
patient groups. Results The average Nursing Activities Score upon admission to the intensive care unit was
61.9, with a score of 52.8 upon discharge. Significant differences were found
among the patients at public and private intensive care units relative to the
average Nursing Activities Score upon admission, as well as for 12 out of 23
nursing interventions performed during the first 24 hours of stay at the intensive
care units. The patients at the public intensive care units exhibited a higher
average score and overall more frequent nursing interventions, with the exception
of those involved in the "care of drains", "mobilization and positioning", and
"intravenous hyperalimentation". The groups also differed with regard to the
evolution of the Nursing Activities Score among the total case series as well as
the groups of survivors from the time of admission to discharge from the intensive
care unit. Conclusion Patients admitted to public and private intensive care units exhibit differences
in their nursing care demands, which may help managers with nursing manpower
planning.
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Nogueira LDS, Domingues CDA, Poggetti RS, de Sousa RMC. Nursing workload in intensive care unit trauma patients: analysis of associated factors. PLoS One 2014; 9:e112125. [PMID: 25375369 PMCID: PMC4223038 DOI: 10.1371/journal.pone.0112125] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 10/12/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND From the perspective of nurses, trauma patients in the Intensive Care Unit (ICU) demand a high degree of nursing workload due to hemodynamic instability and the severity of trauma injuries. This study aims to identify the factors related to the high nursing workload required for trauma victims admitted to the ICU. METHODS This is a prospective, cross-sectional study using descriptive and correlation analyses, conducted with 200 trauma patients admitted to an ICU in the city of São Paulo, Brazil. The nursing workload was measured using the Nursing Activities Score (NAS). The distribution of the NAS values into tertiles led to the identification of two research groups: medium/low workload and high workload. The Chi-square, Fisher's exact, Mann-Whitney and multiple logistic regression tests were utilized for the analyses. FINDINGS The majority of patients were male (82.0%) and suffered blunt trauma (94.5%), with traffic accidents (57.5%) and falls (31.0%) being prevalent. The mean age was 40.7 years (± 18.6) and the mean NAS was 71.3% (± 16.9). Patient gender, the presence of pulmonary failure, the number of injured body regions and the risk of death according to the Simplified Acute Physiology Score II were factors associated with a high degree of nursing workload in the first 24 hours following admission to the ICU. CONCLUSION Workload demand was higher in male patients with physiological instability and multiple severe trauma injuries who developed pulmonary failure.
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Affiliation(s)
- Lilia de Souza Nogueira
- Medical-Surgical Nursing Department, School of Nursing, University of São Paulo, São Paulo, Brazil
| | | | - Renato Sérgio Poggetti
- Department of Surgery, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil
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Argibay-Lago A, Fernández-Rodríguez D, Ferrer-Sala N, Prieto-Robles C, Hernanz-del Río A, Castro-Rebollo P. Valoración de la carga de trabajo de Enfermería en pacientes sometidos a hipotermia terapéutica. ENFERMERIA CLINICA 2014; 24:323-9. [DOI: 10.1016/j.enfcli.2014.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Revised: 07/29/2014] [Accepted: 07/30/2014] [Indexed: 10/24/2022]
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Nursing Activities Score (NAS): 5 Years of experience in the intensive care units of an Italian University hospital. Intensive Crit Care Nurs 2014; 30:152-8. [DOI: 10.1016/j.iccn.2013.10.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Revised: 09/04/2013] [Accepted: 10/24/2013] [Indexed: 11/19/2022]
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Carmona-Monge FJ, Uranga IU, Gómez SG, Herranz CQ, Bengoetxea MB, Unanue GE, Martin AI, Hernando ME, Saralegui EB, Irazoqui MA. [Usage analysis of the Nursing Activities Score in two Spanish ICUS]. Rev Esc Enferm USP 2014; 47:1108-16. [PMID: 24346450 DOI: 10.1590/s0080-623420130000500014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 06/13/2013] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to analyze the discourse of health managers on aspects related to delay in tuberculosis diagnosis. This was a qualitative research study, conducted with 16 Family Health Unit managers. The empirical data were obtained through semi-structured interviews. The analysis was based on the theoretical framework of the French school of discourse analysis. According to the managers' statements, the delay in tuberculosis diagnosis is related to patient and health service aspects. As for patient aspects, managers report fear, prejudice and lack of information as factors that may promote a delayed diagnosis. Regarding health service aspects, structural problems and lack of professional skills were reported. The discourse of managers should be considered to qualify tuberculosis control actions and to prevent delays in diagnosis.
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Affiliation(s)
| | | | - Sonia García Gómez
- Critical Care Unit, University Hospital Alcorcón Foundation, Madrid, Spain
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Panunto MR, Guirardello EDB. Carga de trabalho de enfermagem em Unidade de Terapia Intensiva de um hospital de ensino. ACTA PAUL ENFERM 2012. [DOI: 10.1590/s0103-21002012000100017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Avaliar a carga de trabalho de enfermagem em uma Unidade de Terapia Intensiva (UTI) - adulto e descrever o perfil dos pacientes, nela, internados. MÉTODOS: estudo descritivo com o uso do Nursing Activities Score - NAS durante 33 dias em uma UTI com capacidade para 18 leitos. RESULTADOS: Foram 574 observações, obtidas do registro de 107 pacientes e a média da pontuação do NAS foi de 62,2%. CONCLUSÃO: O NAS constitui-se em um importante instrumento para mensurar a carga de trabalho de enfermagem em UTI, uma vez que contempla diversas atividades de enfermagem realizadas no dia a dia da assistência. Ressalta-se a importância de tornar sua aplicação parte do cotidiano do enfermeiro.
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Coelho FUDA, Queijo AF, Andolhe R, Gonçalves LA, Padilha KG. Carga de trabalho de enfermagem em unidade de terapia intensiva de cardiologia e fatores clínicos associados. TEXTO & CONTEXTO ENFERMAGEM 2011. [DOI: 10.1590/s0104-07072011000400012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O estudo objetivou identificar a carga de trabalho de enfermagem em unidade de Terapia Intensiva de Cardiologia e verificar a associação dessa variável com características demográficas e clínicas dos pacientes. A amostra foi de 100 pacientes internados no período de agosto a setembro de 2006, na Unidade de Terapia Intensiva Cardiológica de um hospital privado, do Município de São Paulo. O Nursing Activities Score, o Symplified Acute Physiologic ScoreII e o Logistic Organ Disfunction System foram utilizados para medir a carga de trabalho de enfermagem, a gravidade e a disfunção orgânica, respectivamente. A carga de trabalho de enfermagem foi de 66,60%, equivalente a 5,30 horas de trabalho, em um turno de oito horas. À exceção do tempo de permanência na Unidade de Terapia Intensiva, que apresentou moderada correlação com a carga de trabalho, não houve associação com as demais variáveis analisadas. Recomenda-se a ampliação da amostra para conclusões generalizáveis.
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Abstract
O estudo teve como objetivos adaptar para o português e avaliar as propriedades psicométricas do Nursing Activities Score (NAS), instrumento de medida de carga de trabalho de enfermagem em UTI. Após o processo de adaptação cultural, o NAS foi aplicado em uma amostra de 200 pacientes adultos internados em UTIs. A análise da consistência interna pelo coeficiente Alfa de Cronbach revelou que o NAS possui 23 medidas independentes que não comportam consolidação ou redução. A avaliação da confiabilidade interobservadores demonstrou alta concordância (99,8%) e índice Kappa médio de 0,99. A validade concorrente foi demonstrada pela correlação estatisticamente significativa entre o TISS-28 e o NAS (r=0,67; p<0,0001), assim como pela análise de regressão multivariada (R²=94,4%; p<0,0001). Na avaliação da validade convergente, a regressão multivariada mostrou associação estatisticamente significativa entre o NAS e o SAPS II, quando ajustada pela idade (R²=99,8%; p<0,0001). Pelos resultados obtidos, o NAS mostrou-se um instrumento confiável e válido para mensurar carga de trabalho de enfermagem em UTIs brasileiras.
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Hall ES, Poynton MR, Narus SP, Jones SS, Evans RS, Varner MW, Thornton SN. Patient-level analysis of outcomes using structured labor and delivery data. J Biomed Inform 2009; 42:702-9. [PMID: 19535002 DOI: 10.1016/j.jbi.2009.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Revised: 12/17/2008] [Accepted: 01/30/2009] [Indexed: 10/21/2022]
Abstract
This paper presents methods for identifying and analyzing associations among nursing care processes, patient attributes, and patient outcomes using unit-level and patient-level representations of care derived from computerized nurse documentation. The retrospective, descriptive analysis included documented nursing events for 900 Labor and Delivery patients at three hospitals over the 2-month period of January and February 2006. Two models were used to produce quantified measurements of nursing care received by each patient. The first model considered only the hourly census of nurses and patients. The second model considered the size of nurses' patient loads as represented by computerized nurse-entered documentation. Significant relationships were identified between durations of labor and nursing care scores generated by the second model. In addition to the clinical associations identified, the study demonstrated an approach with global application for representing the amount of nursing care received at the individual patient level in analyses of patient outcomes.
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Affiliation(s)
- Eric S Hall
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA.
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Hall ES, Poynton MR, Narus SP, Thornton SN. Modeling the distribution of Nursing Effort using structured Labor and Delivery documentation. J Biomed Inform 2008; 41:1001-8. [PMID: 18495549 DOI: 10.1016/j.jbi.2008.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2007] [Revised: 03/13/2008] [Accepted: 04/14/2008] [Indexed: 11/18/2022]
Abstract
Our study objectives included the development and evaluation of models for representing the distribution of shared unit-wide nursing care resources among individual Labor and Delivery patients using quantified measurements of nursing care, referred to as Nursing Effort. The models were intended to enable discrimination between the amounts of care delivered to patient subsets defined by attributes such as patient acuity. For each of five proposed models, scores were generated using an analysis set of 686,402 computerized nurse-documented events associated with 1093 patients at three hospitals during January and February 2006. Significant differences were detected in Nursing Effort scores according to patient acuity, care facility, and in scores generated during shift change versus non-shift change hours. The development of nursing care quantification strategies proposed in this study supports outcomes analysis by establishing a foundation for measuring the effect of patient-level nursing care on individual patient outcomes.
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Affiliation(s)
- Eric S Hall
- Department of Biomedical Informatics, University of Utah, School of Medicine, 26 South 2000 East, Suite 5700 HSEB, Salt Lake City, UT 841112 5750, USA.
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