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Sánchez-Sánchez MM, Campos-Asensio C, Arias-Rivera S. Workloads of intensive care nurses. Validity of their estimation using mobile applications and comparison with Nursing Activities Score. Systematised review of the literature. ENFERMERIA INTENSIVA 2024; 35:229-241. [PMID: 38092607 DOI: 10.1016/j.enfie.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 05/29/2023] [Accepted: 06/01/2023] [Indexed: 07/24/2024]
Abstract
INTRODUCTION Adjusting human resources to intensive care units (ICU) workload is essential. The development of software for estimating nursing workload using mobile devices (smartphone, smartwatch and/or tablets) could be a useful tool and complement and/or improve the measurements made with the Nursing Activities Score (NAS), a validated scale. OBJECTIVES To analyze the validity of devices and mobile applications for estimating ICU nurses' workloads and their comparison with NAS. METHODOLOGY Systematised literature review from 2009 to 2021 informed by flowchart PRISMA-2020 and its extension PRISMA-S. Critical reading (CASPe). Steps:elaboration of the research question, concept identification (English and Spanish natural language and descriptors MesH, Emtree and CINAHL Headings), search strategy and data collection in MEDlars online (MEDLINE), OVID, Excerpta Medica dataBASE (EMBASE), Elsevier, Cumulative Index to Nursing & Allied Health Literature (CINAHL), EBSCO and Web of Science (WoS); data extraction and evaluation, analysis and synthesis of results. We included studies with abstracts published in English and Spanish conducted in ICU with workload measurement (preferably NAS) using mobile devices. RESULTS 223 studies of which 84 in MEDLINE, 50 in CINAHL, 48 in EMBASE, 33 in WOS and 8 in other sources. 117 were eligible for screening, of which 95 did not meet the inclusion criteria. 22 studies were screened for eligibility, of which 17 were excluded. Five articles were selected for final review. None of the studies provided results on costs, acceptance testing, validity, reliability, system problems, advantages, disadvantages or resource estimation. DISCUSSION AND CONCLUSIONS The use of mobile devices and applications to measure ICU workloads is not yet validated and has not been shown to be more accurate than traditional NAS assessment.
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Affiliation(s)
- M M Sánchez-Sánchez
- Unidad de Cuidados Intensivos, Hospital Universitario de Getafe, Madrid, Spain.
| | | | - S Arias-Rivera
- Investigación en Enfermería, Unidad de Cuidados Intensivos, Hospital Universitario de Getafe, Madrid, Spain
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Batterbury A, Douglas C, Jones L, Coyer F. Illness severity characteristics and outcomes of patients remaining on an acute ward following medical emergency team review: a latent profile analysis. BMJ Qual Saf 2023:bmjqs-2022-015637. [PMID: 36657785 DOI: 10.1136/bmjqs-2022-015637] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/05/2023] [Indexed: 01/21/2023]
Abstract
BACKGROUND Patients requiring medical emergency team (MET) review have complex clinical needs, and most remain on the ward after review. Current detection instruments cannot identify post-MET patient requirements, meaning patients remain undistinguished, potentially resulting in missed management opportunities. We propose that deteriorating patients will cluster along dimensions of illness severity and that these clusters may be used to strengthen patient risk management practices. OBJECTIVE To identify and define the number of illness severity clusters and report outcomes among ward patients following MET review. STUDY DESIGN AND SETTING This retrospective cohort study examined the clinical records of 1500 adult ward patients following MET review at an Australian quaternary hospital. Three-step latent profile analysis methods were used to determine clusters using Sequential Organ Failure Assessment (SOFA) and Nursing Activities Score (NAS) as illness severity indicators. Study outcomes were (1) hospital mortality, (2) unplanned intensive care unit (ICU) admission and (3) subsequent MET review. RESULTS Patients were unplanned (73.9%) and medical (57.5%) admissions with at least one comorbidity (51.4%), and complex combinations of acuity (SOFA range 1-17) and dependency (NAS range 22.4%-148.5%). Five clusters are reported. Patients in cluster 1 were equivalent to clinically stable general ward patients. Organ failure and complexity increased with cluster progression-clusters 2 and 3 were equivalent to subspecialty/higher-dependency wards, and clusters 4 and 5 were equivalent to ICUs. Patients in cluster 5 had the greatest odds for death (OR 26.2, 95% CI 23.3 to 31.3), unplanned ICU admission (OR 3.1, 95% CI 3.0 to 3.1) and subsequent MET review (OR 2.4, 95% CI 2.4 to 2.6). CONCLUSION The five illness severity clusters may be used to define patients at risk of poorer outcomes who may benefit from enhanced levels of monitoring and targeted care.
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Affiliation(s)
- Anthony Batterbury
- Safety and Implementation Service, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia .,School of Nursing, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Clint Douglas
- School of Nursing, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Office of Nursing and Midwifery Services, Metro North Hospital and Health Service, Herston, Queensland, Australia
| | - Lee Jones
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,Statistics Unit, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Fiona Coyer
- School of Nursing, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Department of Intensive Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
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Hellín Gil MF, Roldán Valcárcel MD, Seva Llor AM, Ibáñez-López FJ, Mikla M, López Montesinos MJ. Validation of a Nursing Workload Measurement Scale, Based on the Classification of Nursing Interventions, for Adult Hospitalization Units. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15528. [PMID: 36497604 PMCID: PMC9737816 DOI: 10.3390/ijerph192315528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/12/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
UNLABELLED We conducted validation of a scale to measure nursing workloads, previously designed using NIC interventions within the four nursing functions (patient care, teaching, management, and research). METHODS This is an analytical, descriptive, prospective, and observational study using qualitative methodology (focus groups and in-depth interviews) with a quantitative and qualitative section (committee of experts and real application of the scale through a validation pilot and with multicentric application, including hospitalization units of internal medicine and surgery of four hospitals). Qualitative analysis was performed with Atlas.ti8 and quantitative analysis with R. RESULTS Qualitatively, all the participants agreed on the need to measure workloads in all nursing functions with standardized terminology. The expert committee found greater relevance (91.67%) in "prevention" and "health education" as well as consistency with the construct and adequate wording in 99% of the selected items. In the pilot test and multicenter application, the nurses spent more time on the caring dimension, in the morning shift, and on the items "self-care", "medication", "health education", "care of invasive procedures", "wounds care", "comfort", and "fluid therapy". Cronbach's alpha 0.727, composite reliability 0.685, AVE 0.099, and omega coefficient 0.704 were all acceptable. Construct validity: KMO 0.5 and Bartlett's test were significant. CONCLUSIONS The scale can be considered valid to measure nursing workloads, both qualitatively in obtaining the consensus of experts and health personnel and quantitatively, with acceptable reliability and validity superior to other similar scales.
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Affiliation(s)
- María Fuensanta Hellín Gil
- Faculty of Nursing, University of Murcia, 30100 Murcia, Spain
- Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - María Dolores Roldán Valcárcel
- Faculty of Nursing, University of Murcia, 30100 Murcia, Spain
- Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - Ana Myriam Seva Llor
- Faculty of Nursing, University of Murcia, 30100 Murcia, Spain
- Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | | | - Marzena Mikla
- Faculty of Nursing, University of Murcia, 30100 Murcia, Spain
- Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - María José López Montesinos
- Faculty of Nursing, University of Murcia, 30100 Murcia, Spain
- Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
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Hellín Gil MF, Mikla M, Seva Llor AM, Roldán Valcárcel MD, Ibáñez-López FJ, López Montesinos MJ. Multicenter application of a nursing workload measurement scale in adult hospitalization units. Int J Nurs Sci 2022; 9:460-466. [PMID: 36285087 PMCID: PMC9587386 DOI: 10.1016/j.ijnss.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/24/2022] [Accepted: 09/19/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives The study aimed to the multicenter application of a nursing workload measurement scale in the internal medicine and surgery adults hospitalization units. Methods The study design was a multicenter, observational, and descriptive study. A multicenter application of the MIDENF® nursing workload measurement scale was carried out, which consists of 21 items, and covers the four nursing functions (patient care items, teaching, manager, and researcher), in units of hospitalization of adults of internal medicine and surgery of four different hospitals. Each item contains one or more of the nursing interventions of Nursing Interventions Classification (NIC) and has an assigned time, after comparing the real time it takes to perform each intervention with the North American Nursing Diagnosis Association (NANDA) standardized time. The study was carried out during nine months of the year 2020, measuring two days each month in the three work shifts (morning, evening, and night) to all patients admitted on the days of measurement in the indicated units. Results The descriptive and inferential analysis of 11,756 completed scales, 5,695 in general surgery and 6,061 in internal medicine, showed a greater care load for the two units during the morning shift (227,034 min in general surgery, 261,835 min in internal medicine), especially in the items of "self-care", "medication", "common invasive procedures", "fluid therapy", and "patient and family support", while the managerial function was similar during the three work shifts in the two units studied, getting values between 57,348 and 62,901 min. In the analysis by shift and unit, statistical significance was obtained both for the total workload and the four nursing functions(P < 0.001). Conclusions It is shown that the use of validated scales with the standardized language of nursing functions, adapted to the units, provides objective information to adjust the nursing staff to the real situation of care in any hospital and unit where it is applied, improving quality and patient safety.
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Affiliation(s)
| | - Marzena Mikla
- University of Murcia, Murcia, Spain
- Biomedical Research Institute of Murcia (IMIB), Murcia, Spain
| | - Ana Myriam Seva Llor
- University of Murcia, Murcia, Spain
- Biomedical Research Institute of Murcia (IMIB), Murcia, Spain
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Santos LL, Camerini FG, Fassarella CS, Almeida LFD, Setta DXDB, Radighieri AR. Medication time out as a strategy for patient safety: reducing medication errors. Rev Bras Enferm 2021; 74:e20200136. [PMID: 33787789 DOI: 10.1590/0034-7167-2020-0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/16/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to analyze the implementation of the medication time out strategy to reduce medication errors. METHODS this is a quantitative, cross-sectional, inferential study, with direct observation of the implementation of the medication time out strategy, carried out in a cardiac intensive care unit of a university hospital in Rio de Janeiro. RESULTS 234 prescriptions with 2,799 medications were observed. Of the prescriptions analyzed, 143 (61%) had at least one change with the use of the strategy. In the prescriptions altered, 290 medications had some type of change, and 104 (35.9%) changes were related to potentially harmful medication. During the application of the strategy, prescriptions with polypharmacy had 1.8 times greater chance of presenting an error (p-value = 0.031), which reinforces the importance of the strategy for prescriptions with multiple medications. CONCLUSIONS the implementation of the medication time out strategy contributed to the interception of a high number of medication errors, using few human and material resources.
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Affiliation(s)
- Laís Lima Santos
- Universidade do Estado do Rio de Janeiro. Rio de Janeiro, Rio de Janeiro, Brazil
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Fasoi G, Patsiou EC, Stavropoulou A, Kaba E, Papageorgiou D, Toylia G, Goula A, Kelesi M. Assessment of Nursing Workload as a Mortality Predictor in Intensive Care Units (ICU) Using the Nursing Activities Score (NAS) Scale. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010079. [PMID: 33374244 PMCID: PMC7795444 DOI: 10.3390/ijerph18010079] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/20/2020] [Accepted: 12/23/2020] [Indexed: 11/21/2022]
Abstract
Introduction: Nursing activities score scales are valuable instruments for assessing the quality of nursing care provided in critically ill patients and easy to use in validating nurse staffing. The aim of this study was the assessment of nursing workload (NW) as a predictive factor of mortality by using the nursing activities score (NAS) scale. Materials and Methods: In this cross-sectional study of 91 days during 2019, convenience sampling was employed to recruit 82 registered nurses (RN) from three intensive care units (ICUs) of two public hospitals with 41 beds in total. Data were collected using the NAS scale, the researcher’s observation, the information given by the staff, and the nursing care reports. Descriptive and inductive statistics were used with significance level α = 0.05. The Statistical Package for Social Sciences (SPSS 25.0) was used for analyzing the data. Results: Females were the majority of the sample (84.1%), with a mean age of 38.9 (7.7) years, 87.8% had a nursing degree from a technological educational institute (T.E.I), the average working experience was 14 (8.1) years and the ICU experience was 12.9 (8.5) years. There were 3764 daily records of NAS with an average of 54.81 (2.34) and total NAS of 756.51 (150.27). The NW of the first day’s admission in the ICU was 65.15 (13.05), NW was 13.15 h/day and the NW of patients who died was 57.37 (4.06). The optimal nurse/patient ratio (NPR) was 1:1.82, while the existing NPR was 1:2.86. The mortality rate was 28.7%. Conclusion: Although the study results did not demonstrate a significant correlation between NW and mortality, the NW in ICU appeared to be relatively higher for patients who died than for those who survived. This result may serve as an indication for a positive correlation between these two variables. In addition, NW was found to be moderate, while one ICU nurse can take care of more than one patient.
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Affiliation(s)
- Georgia Fasoi
- Department of Nursing, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (G.F.); (A.S.); (D.P.); (G.T.); (M.K.)
| | - Eirini C. Patsiou
- Intensive Care Unit, General Hospital Korgialenio-Benakio E.E.S, 11526 Athens, Greece;
| | - Areti Stavropoulou
- Department of Nursing, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (G.F.); (A.S.); (D.P.); (G.T.); (M.K.)
| | - Evridiki Kaba
- Department of Nursing, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (G.F.); (A.S.); (D.P.); (G.T.); (M.K.)
- Correspondence:
| | - Dimitrios Papageorgiou
- Department of Nursing, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (G.F.); (A.S.); (D.P.); (G.T.); (M.K.)
| | - Georgia Toylia
- Department of Nursing, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (G.F.); (A.S.); (D.P.); (G.T.); (M.K.)
| | - Aspasia Goula
- Department of Business Administration, School of Administrative, Economics and Social Sciences, University of West Attica, 12243 Athens, Greece;
| | - Martha Kelesi
- Department of Nursing, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (G.F.); (A.S.); (D.P.); (G.T.); (M.K.)
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Moghadam KN, Chehrzad MM, Masouleh SR, Mardani A, Maleki M, Akhlaghi E, Harding C. Nursing workload in intensive care units and the influence of patient and nurse characteristics. Nurs Crit Care 2020; 26:425-431. [PMID: 32954619 DOI: 10.1111/nicc.12548] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Understanding factors that can potentially influence patient care and nursing workload in intensive care units is important. Previous studies have shown contradictory outcomes about the relationships between nursing workload and patient and nurse characteristics. AIMS AND OBJECTIVES This study aimed to investigate nursing workload in intensive care units and examine the association between this in relation to patient and nurse characteristics. DESIGN A cross-sectional design was conducted. METHODS All nurses who were working in the intensive care units of five hospitals and met the study criteria were enrolled in the study. Two demographic questionnaires collected nurse and patient demographic information. The Nursing Activities Score was applied to determine nursing workload in three shifts (morning, evening, night) for each nurse. Data were analysed using the independent sample t-test, one-way analysis of variance, and multivariable linear regression analysis. RESULTS The Nursing Activities Score was calculated for 509 patients who were under the care of 105 intensive care unit nurses. The mean (SD) Nursing Activities Score was 72.84% (22.07%). Morning shifts, male patients, medical treatments, and referred patients from the emergency ward and other intensive care units imposed a higher workload for nurses. Specifically, female nurses, increased number of patients receiving care, and increased patient length of intensive care unit stay were directly associated with increased Nursing Activities Scores. Work in surgical and burn intensive care units were inversely associated with the Nursing Activities Score. CONCLUSION This study suggests that the workload of nurses in intensive care units can be affected by both nurse and patient characteristics. RELEVANCE TO CLINICAL PRACTICE The findings can be used to ensure appropriate staffing of intensive care units by nurses. However, nurse and patient characteristics should not be considered the only factors that influence nursing workload in intensive care units.
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Affiliation(s)
| | - Minoo Mitra Chehrzad
- Department of Paediatric Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Shademan Reza Masouleh
- Social Determinants of Health Research Centre (SDHRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Abbas Mardani
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Maleki
- School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Elham Akhlaghi
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Celia Harding
- Division of Language and Communication Science, City, University of London, London, UK
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Mobile application for the evaluation and planning of nursing workload in the intensive care unit. Int J Med Inform 2020; 137:104120. [PMID: 32179255 DOI: 10.1016/j.ijmedinf.2020.104120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 01/06/2020] [Accepted: 03/08/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE In this study, we present an application type software which employs the Nursing Activities Score (NAS), a management tool for measuring nursing workload prospectively. METHOD The system was developed in two modules: WEB (controlled from an Internet browser) for data administration using Java Script; and APP (operated from a smartphone or tablet device) for data acquisition using Hypertext Preprocessor (PHP). White and black box tests were performed in the software. RESULTS A software was developed with an interface that allows the calculation of the scale score by the same professional who provided assistance, generating reports to help nursing management. The functional test was successfully performed using the Android operational system. CONCLUSION The efficiency of the software was demonstrated by the functional test and the main innovations brought herein are the prospective use and the generation of management reports, which can contribute positively by improving nursing quality and safety in the intensive care unit.
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Luna AA, Silva RCLD, Barbosa MTS. The influence of nursing activities score on clinical alarms service. Rev Bras Enferm 2020; 73:e20180963. [DOI: 10.1590/0034-7167-2018-0963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 10/12/2019] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objectives: to estimate the magnitude of the Nursing Activities Score effect on multiparametric monitor alarm response and staff response time. Methods: an observational, cross-sectional study outlined as an open cohort, performed in an Adult General Intensive Care Unit. The time taken for alarms triggered by the multi-parameter monitors was timed and characterized as attended or not. Results: the study obtained a total of 254 alarms triggered from the multiparameter monitors of 63 patients. The mean number of alarms triggered was 4.5 alarms per period/observation and 1.5 alarms/hour. The study showed that the Nursing Activities Score is associated with an additional probability of 4% (p < 0.05) of an alarm being met, for each additional point in the scale, and reduction in team response time. Conclusion: it has been verified that Nursing Activities Score has a direct relationship with the attendance and with the response time to the alarms triggered.
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Silva TCMDSE, Castro MCN, Popim RC. Adaptation of the Nursing Activities Score for oncologic care. Rev Bras Enferm 2018; 71:2383-2391. [PMID: 30304166 DOI: 10.1590/0034-7167-2017-0015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 11/05/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To adapt the contents of the Nursing Activities Score (NAS) tool to assist patients with cancer. METHOD Methodological research that according to the Delphi Technique is a method aiming at the validation of content through agreement of experts. RESULTS It took two rounds of opinion of experts, which added content contributions without modifying the structure and score of the original tool. The level of agreement ranged from 71 to 86%, and biological factors and assistance were more suggested: Monitoring and controls; Laboratory investigations; Support and care for family members and patients; Intravenous replacement; Renal support; Management activities. CONCLUSION A high level of complexity of patients with cancer, and the demand for care and biopsychosocial-spiritual care was diagnosed. This tool will enable the measurement of the workload of the Oncology Nursing team, which can contribute to the staffing dimensioning.
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Affiliation(s)
| | | | - Regina Célia Popim
- Universidade Estadual Paulista Júlio de Mesquita Filho, Botucatu Medical School. Botucatu, São Paulo, Brazil
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Evaluation of Nursing Workload and Efficiency of Staff Allocation in a Trauma Intensive Care Unit. Trauma Mon 2017. [DOI: 10.5812/traumamon.58161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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12
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Ferreira PC, Machado RC, Martins QCS, Sampaio SF. Classification of patients and nursing workload in intensive care: comparison between instruments. ACTA ACUST UNITED AC 2017; 38:e62782. [PMID: 28678901 DOI: 10.1590/1983-1447.2017.02.62782] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 04/18/2017] [Indexed: 11/22/2022]
Abstract
Objectives To evaluate the mean nursing workload obtained through the Nursing Activities Score (NAS) and extract the degree of dependency of patients using Perroca's Patient Classification System (PCS). Methods Prospective study conducted at the intensive care unit of a private hospital that is a center of reference in oncology. The instruments were applied daily in a sample of 40 patients with a minimum stay of 24 hours. Results Two hundred and seventy-seven measurements were performed with the instruments. The NAS mean was 69.8% (± 24.1%) and Perroca's Patient Classification System score was 22.7% (± 4.2%). The hours of care found by averaging NAS were almost twice those estimated by Perroca's, showing a difference of 7.3 hours. Conclusion The direct instrument NAS was more appropriate to measure nursing workload when compared to Perroca's indirect instrument in the studied intensive care unit.
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Affiliation(s)
- Patrícia Cabral Ferreira
- Universidade Federal do Rio Grande do Norte (UFRN), Departamento de Enfermagem, Natal, Rio Grande do Norte, Brasil
| | - Regimar Carla Machado
- Universidade Federal de São Carlos (UFSCar). Departamento de Enfermagem, São Carlos, São Paulo, Brasil
| | - Quênia Camille Soares Martins
- Universidade Federal do Rio Grande do Norte (UFRN). Faculdade de Ciências da Saúde do Trairí, Departamento de Enfermagem. Santa Cruz, Rio Grande do Norte, Brasil
| | - Sueli Fátima Sampaio
- Universidade Federal de São Carlos (UFSCar). Departamento de Enfermagem, São Carlos, São Paulo, Brasil
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Trettene ADS, Fontes CMB, Razera APR, Prado PC, Bom GC, von Kostrisch LM. Sizing of nursing staff associated with self-care promotion in a pediatric semi-intensive care unit. Rev Bras Ter Intensiva 2017; 29:171-179. [PMID: 28977258 PMCID: PMC5496751 DOI: 10.5935/0103-507x.20170027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 02/09/2017] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To calculate and compare the nursing staff size associated with self-care promotion at a pediatric semi-intensive care unit. METHODS This was a prospective study in which 31 children and their caregivers participated. The nursing workload associated with each participant was evaluated at two different times (first and second hospital stays) using the Nursing Activities Score instrument. The first hospital stay corresponded to self-care promotion. Staff size was calculated according to the nursing hours recommended by the Nursing Activities Score instrument and by Conselho Federal de Enfermagem (COFEN) resolution no. 527/16, in the two hospital stays, and the results were compared. RESULTS The nursing workload in the first hospital stay (14.6 hours) was higher than the nursing workload in the second stay (9.9 hours) (p < 0.001). The Nursing Activities Score revealed that according to the nursing hours, the nursing staff size corresponded to 26 and 18 professionals in the first and second hospital stays, respectively, and to 15 professionals according to COFEN resolution no. 527/16. CONCLUSION The number of personnel responsible for promoting self-care in pediatric semi-intensive care units, according to the nursing hours suggested by the Nursing Activities Score, was higher than that recommended by the existing legislation. This demonstrates the necessity of reconsidering staff size for this healthcare profile.
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Affiliation(s)
- Armando dos Santos Trettene
- Programa de Pós-Graduação em Ciências
da Reabilitação, Hospital de Reabilitação de Anomalias
Craniofaciais, Universidade de São Paulo - Bauru (SP), Brasil
| | | | - Ana Paula Ribeiro Razera
- Programa de Pós-Graduação em Ciências
da Reabilitação, Hospital de Reabilitação de Anomalias
Craniofaciais, Universidade de São Paulo - Bauru (SP), Brasil
| | - Priscila Capelato Prado
- Programa de Pós-Graduação em Ciências
da Reabilitação, Hospital de Reabilitação de Anomalias
Craniofaciais, Universidade de São Paulo - Bauru (SP), Brasil
| | - Gesiane Cristina Bom
- Programa de Pós-Graduação em Ciências
da Reabilitação, Hospital de Reabilitação de Anomalias
Craniofaciais, Universidade de São Paulo - Bauru (SP), Brasil
| | - Lilia Maria von Kostrisch
- Programa de Pós-Graduação em Ciências
da Reabilitação, Hospital de Reabilitação de Anomalias
Craniofaciais, Universidade de São Paulo - Bauru (SP), Brasil
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Trettene ADS, Fontes CMB, Razera APR, Gomide MR. Impact of promoting self-care in nursing workload. Rev Esc Enferm USP 2016; 50:635-641. [DOI: 10.1590/s0080-623420160000500014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 05/24/2016] [Indexed: 11/21/2022] Open
Abstract
Abstract OBJECTIVES 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, 1st and 2nd hospitalization, the nursing workload was measured by the Nursing Activities Score (NAS). RESULTS The mean NAS in the 1st hospitalization was 60.9% and in the 2nd 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 1st (p<0.001) and for the 2nd hospitalization (p<0.001), and higher in the first (p<0.001) and in the last day (p=0.025) in the 1st hospitalization. Comparing the 1st hospitalization to the 2nd 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.
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