Edyta K Cudak1, Danuta Dyk. 1. Zakład Pielegniarstwa Anestezjologicznego i Intensywnej Opieki, Uniwersytet Medyczny w Poznaniu. edytacud@ump.edu.pl
Abstract
BACKGROUND: The cost of nursing in a modern hospital can take up to 50% of the total budget. Therefore, it is very important to use objective tools for assessment of the nursing workload and adjust staff requirements accordingly. The purpose of the study was to evaluate nursing workload using the Nursing Activities Score (NAS) in intensive care units. METHODS: This prospective analysis of nursing care of 314 adult patients was performed simultaneously in five intensive care units in Poland. NAS was used for the evaluation of nursing workload and the APACHE II score was used for assessment of the severity of cases. The APACHE score was calculated during the first 24 hours of ICU stay, while the NAS was recorded over an entire stay. RESULTS: The average age of the patients was 58.4 +/- 16.6 years. The length of stay was 8.7 +/- 11.4 days. The distribution between surgical (56%) and non-surgical cases (44%) was almost equal. Mortality was 21%. The median APACHE II score was 20 (1-42) and the NAS score 84.4%. There was no correlation between patients' clinical condition and nursing workload (p > 0.05), and the workload in surgical and non-surgical patients. The NAS score correlated well with the length of stay (p < 0.05). CONCLUSION: The study showed that ICU nurses spend 84.4% of their working time by the patient's bed. The optimal ICU nurse: patient ratio was estimated to be 1:1.2.
BACKGROUND: The cost of nursing in a modern hospital can take up to 50% of the total budget. Therefore, it is very important to use objective tools for assessment of the nursing workload and adjust staff requirements accordingly. The purpose of the study was to evaluate nursing workload using the Nursing Activities Score (NAS) in intensive care units. METHODS: This prospective analysis of nursing care of 314 adult patients was performed simultaneously in five intensive care units in Poland. NAS was used for the evaluation of nursing workload and the APACHE II score was used for assessment of the severity of cases. The APACHE score was calculated during the first 24 hours of ICU stay, while the NAS was recorded over an entire stay. RESULTS: The average age of the patients was 58.4 +/- 16.6 years. The length of stay was 8.7 +/- 11.4 days. The distribution between surgical (56%) and non-surgical cases (44%) was almost equal. Mortality was 21%. The median APACHE II score was 20 (1-42) and the NAS score 84.4%. There was no correlation between patients' clinical condition and nursing workload (p > 0.05), and the workload in surgical and non-surgical patients. The NAS score correlated well with the length of stay (p < 0.05). CONCLUSION: The study showed that ICU nurses spend 84.4% of their working time by the patient's bed. The optimal ICU nurse: patient ratio was estimated to be 1:1.2.