Financial impact of nursing professionals staff required in an Intensive Care Unit

Hypothermia post-cardiopulmonary resuscitation with low inputs: an experience report

OBJECTIVE

to report the experience of conducting directed temperature control of a post-cardiopulmonary resuscitation patient, with reduced and basic inputs available at the institution.

METHOD

an experience report of directed temperature control in patient (age 15 years), after four hours of cardiopulmonary resuscitation in an Intensive Care Unit of a hospital in São Paulo State countryside in 2016, according to the protocol suggested by the American Heart Association, in 2015. There were applications of cold compresses, plastic bags with crushed ice and rectal temperature control.

RESULTS

after eight hours, temperature had reached 93.2 ºF. Body cooling was maintained for 24 hours. However, bags with crushed ice were used in the first 6 hours.

CONCLUSION

conduct of nurses to obtain the body cooling with reduced and basic inputs was effective during the stay at the Intensive Care Unit.

Association between patient classification systems and nurse staffing costs in intensive care units: An exploratory study

OBJECTIVES

Nurse staffing costs represent approximately 60% of total intensive care unit costs. In order to analyse resource allocation in intensive care, we examined the association between nurse staffing costs and two patient classification systems: the nursing activities score (NAS) and nine equivalents of nursing manpower use score (NEMS).

RESEARCH METHODOLOGY/DESIGN

A retrospective descriptive correlational analysis of nurse staffing costs and data of 6390 patients extracted from a data warehouse.

SETTING

Three intensive care units in a university hospital and one in a regional hospital in Norway.

MAIN OUTCOME MEASURES

Nurse staffing costs, NAS and NEMS.

RESULTS

For merged data from all units, the NAS was more strongly correlated with monthly nurse staffing costs than was the NEMS. On separate analyses of each ICU, correlations were present for the NAS on basic costs and external overtime costs but were not significant. The annual mean nurse staffing cost for 1% of NAS was 20.9-23.1 euros in the units, which was comparable to 53.3-81.5 euros for 1 NEMS point.

CONCLUSION

A significant association was found between monthly costs, NAS, and NEMS. Cost of care should be based on individual patients' nursing care needs. The NAS makes nurses' workload visible and may be a helpful classification system in future planning and budgeting of intensive care resources.

Ambiente da prática de enfermagem em unidades de terapia intensiva

Resumo Objetivo Analisar o ambiente da prática de enfermagem em unidades de terapia intensiva. Métodos Estudo descritivo, de abordagem quantitativa, realizado com 209 profissionais de enfermagem de três hospitais de ensino brasileiros. O ambiente da prática de enfermagem foi avaliado através da Practice Environment Scale. Os dados foram analisados descritivamente, assumindo nível de significância de 5% (p<0,05). O coeficiente Alfa de Cronbach foi utilizado para examinar a consistência interna dos construtos. Resultados Os profissionais de enfermagem consideraram desfavoráveis quatro das cinco dimensões do ambiente da prática profissional: participação dos enfermeiros na discussão dos assuntos hospitalares; fundamentos de enfermagem voltados para a qualidade do cuidado, habilidade, liderança e suporte dos coordenadores/supervisores de enfermagem aos enfermeiros/equipe de enfermagem; e adequação da equipe e de recursos. Apenas a dimensão relações colegiais entre profissionais de enfermagem e médicos apresentou avaliação positiva. Enfermeiros reconheceram mais fortemente atributos desfavoráveis no ambiente de prática do que técnicos de enfermagem. Conclusão O ambiente mostrou-se desfavorável para a prática dos profissionais de enfermagem. Esforços são necessários para tornar o ambiente de prática mais atrativo aos profissionais de enfermagem, e assim estimular melhorias na qualidade e na segurança da assistência prestada.