Gutiérrez-Abarca Amaia, Casado-Álvarez Alberto, Espinosa-Carcabilla Sare
Unidad de Reanimación, Hospital Universitario de Cruces (OSI Ezkerraldea-Enkarterri-Cruces), Barakado, Bizkaia, Spain.
Unidad de Reanimación, Hospital Universitario de Cruces (OSI Ezkerraldea-Enkarterri-Cruces), Barakado, Bizkaia, Spain.
Enferm Intensiva (Engl Ed). 2025 Apr-Jun;36(2):500535. doi: 10.1016/j.enfie.2025.500535. Epub 2025 May 6.
A poor Nurse-to-Patient (N:P) ratio has a negative impact on the health of both patients and professionals. There are several tools to quantify the Nurse Workload (NW) and adjust nurse staffing. The use of such tools in the Intensive Care Units (ICU) can facilitate the adaptation of Nursing resources to patients' real needs and improve working conditions.
To determine the NW in a Surgical ICU.
Descriptive, transversal and unicentric study during March and April 2023. Determination of the operative N:P ratio adequated to the NW using the "Nursing Activities Score" (NAS). Measurement of the NW using NAS and "Valoración de Cargas de Trabajo y Tiempos de Enfermería" (VACTE) scales, together with the proposed NW indicators. Management and efficiency analysis of the Nursing Resources using the "Work Utilization Ratio" Index (WUR). Identification of work days and shifts with greater workload. Bivariate analysis relating NAS and VACTE to reason for admission. Calculation of the NW of each reason for admission relating the stay average and its NAS and VACTE average. Correlation analysis between scales.
1705 records per scale were collected. NAS per patient median: 55.70 (IR: 51.30-60.38), (95%CI: 54.74-56.66). NAS per patient mean: 56,67 (SD: ±8,28), (95%CI: 55.72-57.63). NW per bed NAS: 63.39, VACTE: 652.93. NAS per nurse: 135.23%. B:P Ratio: 1:1.09. Operative N:P Ratio: 1:1.76. WUR > 1. Correlation coefficient between scales: 0.45.
There is a shortage of nurses in relation to the work generated. An update in the scales is required. The NAS per nurse is more effective than the NAS per patient for the adequacy of the Nursing workforce. The new proposed indicators might be suitable to determine the NW and to optimize the calculation of Nursing resources.
护患比例不佳会对患者和医护人员的健康产生负面影响。有多种工具可用于量化护士工作量（NW）并调整护士人员配置。在重症监护病房（ICU）使用此类工具可促进护理资源与患者实际需求相匹配，并改善工作条件。
确定外科ICU的护士工作量。
2023年3月至4月进行描述性、横断面和单中心研究。使用“护理活动评分”（NAS）确定与护士工作量相适应的实际护患比例。使用NAS和“护理工作量与时间评估”（VACTE）量表以及提议的护士工作量指标来测量护士工作量。使用“工作利用率”指数（WUR）对护理资源进行管理和效率分析。确定工作量较大的工作日和班次。对NAS和VACTE与入院原因进行双变量分析。计算每种入院原因的护士工作量，将住院平均时间与其NAS和VACTE平均值相关联。对各量表进行相关性分析。
每个量表收集了1705条记录。每位患者的NAS中位数：55.70（四分位间距：51.30 - 60.38），（95%置信区间：54.74 - 56.66）。每位患者的NAS平均值：56.67（标准差：±8.28），（95%置信区间：55.72 - 57.63）。每张床位的NAS护士工作量：63.39，VACTE：652.93。每位护士的NAS：135.23%。护患比：1:1.09。实际护患比例：1:1.76。WUR > 1。各量表之间的相关系数：0.45。
相对于产生的工作量而言，护士短缺。量表需要更新。就护理人力充足而言，每位护士的NAS比每位患者的NAS更有效。新提议的指标可能适用于确定护士工作量并优化护理资源的计算。
