Nursing workload on the day of discharge from the intensive care unit is associated with readmission

Author(s):  
Angelina V. Azevedo ◽  
Tiago A. Tonietto ◽  
Márcio M Boniatti
2018 ◽  
Vol 24 (6) ◽  
pp. 381-386 ◽  
Author(s):  
Ester Góes Oliveira ◽  
Paulo Carlos Garcia ◽  
Clairton Marcos Citolino Filho ◽  
Lilia Nogueira

2017 ◽  
Vol 70 (3) ◽  
pp. 475-480 ◽  
Author(s):  
Filipe Utuari de Andrade Coelho ◽  
Mirian Watanabe ◽  
Cassiane Dezoti da Fonseca ◽  
Katia Grillo Padilha ◽  
Maria de Fátima Fernandes Vattimo

ABSTRACT Objective: to evaluate the nursing workload in intensive care patients with acute kidney injury (AKI). Method: A quantitative study, conducted in an intensive care unit, from April to August of 2015. The Nursing Activities Score (NAS) and Kidney Disease Improving Global Outcomes (KDIGO) were used to measure nursing workload and to classify the stage of AKI, respectively. Results: A total of 190 patients were included. Patients who developed AKI (44.2%) had higher NAS when compared to those without AKI (43.7% vs 40.7%), p <0.001. Patients with stage 1, 2 and 3 AKI showed higher NAS than those without AKI. A relationship was identified between stage 2 and 3 with those without AKI (p = 0.002 and p <0.001). Conclusion: The NAS was associated with the presence of AKI, the score increased with the progression of the stages, and it was associated with AKI, stage 2 and 3.


2019 ◽  
Vol 9 (9) ◽  
pp. 104
Author(s):  
Fabiola Alves Gomes ◽  
Denise Von Dolinger de Brito Röder ◽  
Thúlio Marquez Cunha ◽  
Rosângela De Oliveira Felice ◽  
Guilherme Silva Mendonça ◽  
...  

Objective: Evaluate the relation of nursing workload, evaluated by the Nursing Activities Score (NAS), with the occurrence of Ventilator-associated Pneumonia (VAP) in an Intensive Care Unit (ICU) and the impact of VAP on hospitalization costs.Methods: Retrospective cohort study in Adult ICU of a high complexity Brazilian university hospital. The profile, outcomes, costs, and daily NAS from patients were collected. We also proposed some workload indicators based on NAS daily evaluation.Results: The study included 195 patients, 27.17% diagnosed with VAP. VAP was more prevalent in patients diagnosed with trauma on admission. The total costs of care were higher for VAP patients. In all multivariate models tested were predictive for VAP: the patient's intubation that occurs in days prior of the ICU admission day (higher risk if occurs in days prior the ICU admission day) and ventilation time prior ICU (higher risk if higher time). We found others predictors, but these were dependent on the model tested. Additional risk predictors were tracheostomy, propofol use, neuromuscular blocker use and the higher NAS from admission. The protective factors found were the percentage of adequacy of the assignment based in NAS that measure if the workload measured by the NAS was offered and the increment in NAS during the ventilation time.Conclusions: The offering of an adequate nursing work scale (adequate number of professionals for the care), as a function of the nursing workload measured by the NAS, could be effective in the reduction of VAP, hospital stay time and hospital costs.


2016 ◽  
Vol 50 (4) ◽  
pp. 683-694 ◽  
Author(s):  
Andrea Carvalho de Oliveira ◽  
Paulo Carlos Garcia ◽  
Lilia de Souza Nogueira

Abstract OBJECTIVE To identifyevidences of the influence of nursing workload on the occurrence of adverse events (AE) in adult patients admitted to the intensive care unit (ICU). METHOD A systematic literature review was conducted in the databases MEDLINE, CINAHL, LILACS, SciELO, BDENF, and Cochrane from studies in English, Portuguese, or Spanish, published by 2015. The analyzed AE were infection, pressure ulcer (PU), patient falls, and medication errors. RESULTS Of 594 potential studies, eight comprised the final sample of the review. TheNursing Activities Score (NAS; 37.5%) and the Therapeutic Intervention Scoring System(TISS; 37.5%) were the instruments most frequently used for assessing nursing workload. Six studies (75.0%) identified the influence of work overload in events of infection, PU, and medicationerrors. An investigation found that the NAS was a protective factor for PU. CONCLUSION The nursing workload required by patients in the ICU influenced the occurrence of AE, and nurses must monitor this variable daily to ensure proper sizing of staff and safety of care.


2017 ◽  
Vol 70 (5) ◽  
pp. 942-948 ◽  
Author(s):  
Clarita Terra Rodrigues Serafim ◽  
Magda Cristina Queiroz Dell’Acqua ◽  
Meire Cristina Novelli e Castro ◽  
Wilza Carla Spiri ◽  
Hélio Rubens de Carvalho Nunes

ABSTRACT Objective: To analyze whether an increase in patient severity and nursing workload are correlated to a greater incidence of adverse events (AEs) in critical patients. Method: A prospective single cohort study was performed on a sample of 138 patients hospitalized in an intensive care unit (ICU). Results: A total of 166 AEs, occurred, affecting 50.7% of the patients. Increased patient severity presented a direct relationship to the probability of AEs occurring. However, nursing workload did not present a statistically significant relationship with the occurrence of AEs. Conclusion: The results cast light on the importance of using evaluation tools by the nursing personnel in order to optimize their daily activities and focus on patient safety.


2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Ana Tamara Kolecha Giordani Grebinski ◽  
Francislene Aparecida Biederman ◽  
Caroline Berte ◽  
Grasiely Masotti Scalabrin Barreto ◽  
João Lucas Campos De Oliveira ◽  
...  

Objetivo: Mensurar a carga de trabalho da equipe de enfermagem de uma Unidade de Terapia Intensiva Neonatal (UTIN) e dimensionar o quadro de pessoal necessário para o suprimento desta demanda. Metodologia: Estudo transversal, documental e quantitativo. Foram coletadas variáveis de caracterização clínica e demográfica da amostra (n=105) de recém-nascidos e da carga de trabalho da enfermagem por meio do Nursing Activities Score (NAS). O dimensionamento foi calculado com base em equação para terapia intensiva e ajustado à Resolução nº 543/2017 do Conselho Federal de Enfermagem. Resultados: A média do NAS da UTIN foi de 749,9. Obteve-se quadro dimensionado de 43 profissionais, com déficit de 17 enfermeiros em comparação ao quadro disponível. Conclusão: O quadro de enfermeiros da UTIN é insuficiente.Descritores: Carga de trabalho; Dimensionamento; Equipe de enfermagem; Unidades de terapia intensiva neonatal.WORKLOAD AND SIZING OF THERAPY IN NURSING STAFF INTENSIVE NEWBORNObjective: To measure the workload of the nursing team of a Neonatal Intensive Care Unit (NICU) and to size the personnel needed to supply this demand. Method: Cross-sectional, documentary and quantitative study. Clinical and demographic characterization variables of the sample (n = 105) of newborns and the nursing workload were collected through the Nursing Activities Score (NAS). The design was calculated based on a formula for intensive therapy and adjusted to Resolution 543/2017 of the Federal Nursing Council. Results: The mean of the NICU NAS was 749.9. It was obtained a dimensioned picture of 43 professionals, with a deficit of 17 nurses in comparison to the available picture. Conclusion: Nurses from the NICU are insufficient.Descriptors: Workload; Sizing; Nursing team; Neonatal intensive care units.CARGA DE TRABAJO Y DIMENSIONAMIENTO DE PERSONAL DE ENFERMERÍA EN TERAPIA INTENSIVA NEONATALObjetivo: Medir la carga de trabajo del equipo de enfermería de una Unidad de Terapia Intensiva Neonatal (UTIN) y dimensionar el cuadro de personal necesario para el aprovisionamiento de esta demanda. Metodologia: Estudio transversal, documental y cuantitativo. Se recogieron variables de caracterización clínica y demográfica de la muestra (n = 105) de recién nacidos y de la carga de trabajo de la enfermería por medio del Nursing Activities Score (NAS). El dimensionamiento fue calculado con base en fórmula para terapia intensiva y ajustado a la Resolución 543/2017 del Consejo Federal de Enfermería. Resultados: El promedio del NAS de la UTIN fue de 749,9. Se obtuvo un cuadro dimensionado de 43 profesionales, con déficit de 17 enfermeros en comparación al cuadro disponible. Conclusión: El cuadro de enfermeros de la UTIN es insuficiente.Descriptores: Carga de trabajo; Dimensionamiento; Equipo de enfermería; Unidades de terapia intensiva neonatal.


2014 ◽  
Vol 26 (1) ◽  
pp. 36-43 ◽  
Author(s):  
Andriza Oliveira Moschetta Campagner ◽  
Pedro Celiny Ramos Garcia ◽  
Jefferson Pedro Piva

2019 ◽  
Vol 18 (4) ◽  
pp. 485-528
Author(s):  
Raiane Antonia Santos Nobre ◽  
Hertaline Menezes do Nascimento Rocha ◽  
Fernanda de Jesus Santos ◽  
Allan Dantas Dos Santos ◽  
Rafaela Gois De Mendonça ◽  
...  

Objective: To compare the nursing workload measured by the Nursing Activities Score (NAS), between intensive care unit general adult ICU, and specialized surgical, cardiologic and trauma type.Methods: A literature review of the integrative type was carried out, searching the databases BDENF, LILACS, MEDLINE, and SCIELO, using the descriptors nursing, Intensive Care Unit, workload and Nursing Activities Score. They met the inclusion criteria 20 articles published in the period 2007 to 2017.Results: They show a high workload in the ICU, both in general ICUs and in all of the cited specificities, the same with a NAS score> 50.00, especially the trauma ICU, which was characterized with higher scores 72.00 and 71.3.Conclusion: In much of the research, the average number of nursing professionals calculated by the NAS is higher than the average number of professionals required by the legislation. It was observed that even in ICUs with the same specificity it was possible to perceive large differences in the mean of the NAS score, in this way, we understand that despite having the same specificity, the profile of the patient as well as that of the institution has its peculiarities requiring time to different assistance and consequently divergences in sizing. Objetivo: Comparar la carga de trabajo de enfermería medida por la Nursing Activities Score (NAS), entre la unidad de cuidados intensivos general de adultosy especializadas de quirúrgico, cardiología y trauma.Métodos: Realización de una revisión de la literatura del tipo integrativa. Búsqueda en las bases de datos BDENF, LILACS, MEDLINE, SCIELO, utilizando los descriptores enfermería, Unidad de Cuidados Intensivos, Carga de trabajo y Nursing Activities Score. Atendieron a los criterios de inclusión 20 artículos publicados en el periodo de 2007 a 2017.Resultados: Evidencian elevada carga de trabajo en UCI, tanto en UCIs general como en todas las especificidades citadas, las mismas con puntuación NAS > 50,00, destacando la UCI de trauma lo que se caracterizó con mayores marcadores 72,00 y 71,3.Conclusión: En gran parte de las investigaciones, la media de profesionales de enfermería calculada por la NAS es superior a la media de profesionales requerida por la legislación. Se observó que incluso en UCIs con la misma especificidad se perciben grandes diferencias en la media de la puntuación NAS, de esta forma, entendemos que a pesar de tener la misma especificidad, el perfil del paciente así como el de la institución tienen sus particularidades demandando tiempo de asistencia diferente y consecuentemente divergencias en el dimensionamiento. Objetivo: Comparar a carga de trabalho de enfermagem medida pelo Nursing Activities Score (NAS), entre unidade de terapia intensiva UTI geral adulto, e especializadas do tipo cirúrgica, cardiológica e trauma.Métodos: Foi realizada uma revisão de literatura do tipo integrativa, com busca nas bases de dados BDENF, LILACS, MEDLINE, e SCIELO, utilizando-se os descritores enfermagem, Unidade de Terapia Intensiva, carga de trabalho e Nursing Activities Score. Atenderam aos critérios de inclusão 20 artigos publicados no período de 2007 a 2017.Resultados: Evidenciam elevada carga de trabalho em UTI, tanto em UTIs geral quanto em todas as especificidades citadas, as mesmas com pontuação NAS > 50,00, destacando-se a UTI de trauma o que caracterizou-se com maiores escores 72,00 e 71,3.Conclusão: Em grande parte das pesquisas, a média de profissionais de enfermagem calculada pelo NAS é superior à média de profissionais requerida pela legislação. Observou-se que mesmo em UTIs com a mesma especificidade pôde-se perceber grandes diferenças na média do escore NAS, dessa forma, entendemos que apesar de possuir a mesma especificidade, o perfil do paciente assim como o da instituição tem suas particularidades demandando tempo de assistência diferente e consequentemente divergências no dimensionamento.


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