Department of Medical-Surgical Nursing, School of Nursing, University of São Paulo, São Paulo, Brazil.
Department of Nursing, University Hospital, University of São Paulo, São Paulo, Brazil.
Nurs Crit Care. 2019 Nov;24(6):387-391. doi: 10.1111/nicc.12408. Epub 2019 Jul 11.
According to the perception of nurses in the intensive care unit (ICU), surgical patients need more nursing care, thus requiring higher nursing workloads for these patients than those admitted as clinical patients. However, some study results on the relationship between the type of admission and the nursing workload are considered contradictory.
To identify if the type of admission (clinical, emergency surgery or elective surgery) is a predictive factor of the nursing workload required by patients on the first day or throughout their stay in the ICU.
This was a quantitative cross-sectional study comprised of a retrospective analysis of clinical records of critical patients.
Data were collected from 1 May 2015 to 30 September 2015 in a hospital located in São Paulo, Brazil. Nursing workload was measured using the Nursing Activities Score. The type of admission and the demographic and clinical variables of the patients were investigated. Multiple linear regression was used to identify nursing workload predictive factors, with 5% significance level.
In the analysed sample (n = 211; mean age of 60·3 ± 18·7 years), there was a prevalence of male gender (56·9%). A statistically significant difference (p = 0·025) was found between the type of admission and the nursing workload required for patients on the first ICU day. The Simplified Acute Physiologic Score (p = 0·009) was a predictor of nursing workload on the first day in the ICU, and the Logistic Organ Dysfunction System (p = 0·026) and mortality (p < 0·001) were predictors throughout the ICU stay.
The type of admission was not a predictive factor of the nursing workload required by critical patients.
Identifying the predictive factors of nursing workload favours the appropriate staffing of the critical unit by nurses. However, nurses should not consider the type of admission in predicting the nursing workload required by patients in the ICU.
根据重症监护病房（ICU）护士的感知，外科患者需要更多的护理，因此与作为临床患者入院的患者相比，这些患者需要更高的护理工作量。然而，一些关于入院类型与护理工作量之间关系的研究结果被认为存在矛盾。
确定入院类型（临床、急诊手术或择期手术）是否是患者在 ICU 入住第一天或整个入住期间所需护理工作量的预测因素。
这是一项定量的横断面研究，包括对危重症患者临床记录的回顾性分析。
数据于 2015 年 5 月 1 日至 9 月 30 日在巴西圣保罗的一家医院收集。护理工作量使用护理活动评分进行测量。调查了患者的入院类型和人口统计学及临床变量。使用多元线性回归确定护理工作量的预测因素，显著性水平为 5%。
在分析样本（n=211；平均年龄 60.3±18.7 岁）中，男性（56.9%）占多数。入院类型与患者在 ICU 入住第一天所需护理工作量之间存在统计学显著差异（p=0.025）。简化急性生理评分（p=0.009）是 ICU 入住第一天护理工作量的预测因素，而逻辑器官功能障碍系统（p=0.026）和死亡率（p<0.001）是整个 ICU 入住期间的预测因素。
入院类型不是危重症患者所需护理工作量的预测因素。
确定护理工作量的预测因素有利于护士对重症监护病房进行适当的人员配置。然而，护士在预测 ICU 患者所需的护理工作量时不应考虑入院类型。
