Does the APACHE II scoring system equate with the Nottingham Patient Dependency System? Can these systems be used to determine nursing workload and skill mix?

The development of a holistic patient dependency system for intensive care in Nottingham has enabled nursing staff to analyse their patient's needs more comprehensively and relate them to existing staffing levels. A recent publication (Chellel et al., 1995) implied that some units were using medical scoring systems to predict workload and that practitioners were dissatisfied with current scoring systems. Patient dependency scores were correlated with APACHE II scores by regression analysis on 1,743 patients from the Adult Intensive. Care Unit at the University Hospital, Nottingham. Analysis revealed that APACHE II had little ability to predict patient dependency and, therefore, is unreliable at predicting nursing workload and skill mix.