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某大学医院重症监护病房的护理活动评分与工作量

Nursing Activities Score and workload in the intensive care unit of a university hospital.

作者信息

Altafin Juliana Aparecida Morini, Grion Cintia Magalhães Carvalho, Tanita Marcos Toshyiuki, Festti Josiane, Cardoso Lucienne Tibery Queiroz, Veiga Caio Fabrício Fonseca, Kamiji Danielle, Barbosa Álan Roger Gomes, Matsubara Caio Cesar Takeshi, Lara Aline Bobato, Lopes Cesar Castello Branco, Blum Djavani, Matsuo Tiemi

机构信息

Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Londrina, Londrina, PR, Brasil.

Departamento de Clínica Médica, Universidade Estadual de Londrina, Londrina, PR, Brasil.

出版信息

Rev Bras Ter Intensiva. 2014 Jul-Sep;26(3):292-8. doi: 10.5935/0103-507x.20140041.

Abstract

OBJECTIVE

The nursing workload consists of the time spent by the nursing staff to perform the activities for which they are responsible, whether directly or indirectly related to patient care. The aim of this study was to evaluate the nursing workload in an adult intensive care unit at a university hospital using the Nursing Activities Score (NAS) instrument.

METHODS

A longitudinal, prospective study that involved the patients admitted to the intensive care unit of a university hospital between March and December 2008. The data were collected daily to calculate the NAS, the Acute Physiology and Chronic Health Evaluation (APACHE II), the Sequential Organ Failure Assessment (SOFA) and the Therapeutic Intervention Scoring System (TISS-28) of patients until they left the adult intensive care unit or after 90 days of hospitalization. The level of significance was set at 5%.

RESULTS

In total, 437 patients were evaluated, which resulted in an NAS of 74.4%. The type of admission, length of stay in the intensive care unit and the patients' condition when leaving the intensive care unit and hospital were variables associated with differences in the nursing workload. There was a moderate correlation between the mean NAS and APACHE II severity score (r=0.329), the mean organic dysfunction SOFA score (r=0.506) and the mean TISS-28 score (r=0.600).

CONCLUSION

We observed a high nursing workload in this study. These results can assist in planning the size of the staff required. The workload was influenced by clinical characteristics, including an increased workload required for emergency surgical patients and patients who died.

摘要

目的

护理工作量由护理人员为履行其职责所花费的时间组成,无论这些职责与患者护理直接或间接相关。本研究的目的是使用护理活动评分(NAS)工具评估某大学医院成人重症监护病房的护理工作量。

方法

一项纵向、前瞻性研究,纳入了2008年3月至12月期间入住该大学医院重症监护病房的患者。每天收集数据,以计算患者的NAS、急性生理与慢性健康状况评分系统(APACHE II)、序贯器官衰竭评估(SOFA)和治疗干预评分系统(TISS - 28),直至患者离开成人重症监护病房或住院90天后。显著性水平设定为5%。

结果

共评估了437例患者,NAS为74.4%。入院类型、在重症监护病房的住院时间以及患者离开重症监护病房和医院时的状况是与护理工作量差异相关的变量。平均NAS与APACHE II严重程度评分(r = 0.329)、平均器官功能障碍SOFA评分(r = 0.506)和平均TISS - 28评分(r = 0.600)之间存在中度相关性。

结论

我们在本研究中观察到较高的护理工作量。这些结果有助于规划所需的工作人员规模。工作量受临床特征影响,包括急诊手术患者和死亡患者所需的工作量增加。

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