Lucchini Alberto, Chinello Valeria, Lollo Veronica, De Filippis Cristian, Schena Michela, Elli Stefano, Sasso Maurizio, Pelucchi Giulia, Poloniato Laura, Martino Maria, Costanzo Angelo, Vimercati Simona
Dipartimento di medicina perioperatoria e terapie intensive -Teropia intensiva generale AO S. Gerardo, Monza, Università Milano-Bicocca.
Assist Inferm Ric. 2008 Jan-Mar;27(1):18-26.
NEMS and NAS scoring systems allow to calculate the number of nurses needed in an intensive care unit. Aim of the study is the assessment of nursing workload in a polyvalent intensive care unit, the evaluation of easiness of routine use of the systems and the assessment of the number of nurses needed.
The NEMS and NAS scores of 752 patients admitted respectively from may 2004 and July 2006 and of 250 patients admitted from August 2006 to July 2007 were analysed and adjusted to the number of inpatients.
Mean NEMS score were 32.05 (+/- 2.11) and mean NAS scores 76.17 (+/- 14.66) and minutes of care needed per day 1009 according to NEMS and 1096 according to NAS. Medical patients have an higher workload compared to surgical (NAS Score 84.2 +/- 16.4 vs 79.0 +/- 12.4, p = 0.0047). The workload is influenced by the main illness (extracorporeal circulation: 102.26 +/- 5.70, shock. 88.00 +/- 1 7.48, cardio-circulatory arrest out of the ward: 81.95 +/- 15.46, ARDS 86.62 +/- 14.10) and by the day of admission, being higher at admission.
The routine assessment of patients' workload allows to measure the gap between nurses needed and available, to monitor patients with higher workload and to quantify the need of nursing care according to patients case-mix.
NEMS和NAS评分系统可用于计算重症监护病房所需护士数量。本研究旨在评估综合重症监护病房的护理工作量，评估这些系统常规使用的便捷性，并评估所需护士数量。
分析了2004年5月至2006年7月收治的752例患者以及2006年8月至2007年7月收治的250例患者的NEMS和NAS评分，并根据住院患者数量进行了调整。
NEMS平均评分为32.05（±2.11），NAS平均评分为76.17（±14.66），根据NEMS计算每天所需护理分钟数为1009，根据NAS计算为1096。内科患者的工作量高于外科患者（NAS评分84.2±16.4对79.0±12.4，p = 0.0047）。工作量受主要疾病（体外循环：102.26±5.70，休克88.00±17.48，病房外心脏骤停：81.95±15.46，急性呼吸窘迫综合征86.62±14.10）和入院日期影响，入院时工作量较高。
对患者工作量进行常规评估有助于衡量所需护士与现有护士之间的差距，监测工作量较高的患者，并根据患者病例组合量化护理需求。
