Instruments to measure complexity of care based on nursing workload in intensive care units: A systematic review

IF 4.9 2区医学 Q1 NURSING Intensive and Critical Care Nursing Pub Date : 2024-05-01 DOI:10.1016/j.iccn.2024.103672

{"title":"Instruments to measure complexity of care based on nursing workload in intensive care units: A systematic review","authors":"","doi":"10.1016/j.iccn.2024.103672","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To establish an evidence-based recommendation on the use of validated scoring systems that measure nursing workload in relation to the complexity of care in adult Intensive Care Units.</p></div><div><h3>Methods</h3><p>A systematic review based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) was conducted (PROSPERO registration: CRD42021251272). We searched for validation studies until July 2023 using the bibliographic databases CINAHL, Scopus, Pubmed, WOS, Cochrane Database, SCIELO, Cuiden and Cuidatge. Reference selection and data extraction was performed by two independent reviewers. The assessment of risk of bias was performed using QUADAS-2 and the overall quality according to COSMIN and GRADE approach.</p></div><div><h3>Results</h3><p>We included 22 articles identifying 10 different scoring systems. Reliability, criterion validity and hypothesis testing were the most frequently measurement properties reported. The NAS was the only tool to demonstrate a Class A recommendation (the best performing instrument).</p></div><div><h3>Conclusions</h3><p>NAS is the best currently available scoring system to assess complexity of care from nursing workload in ICU. However, it barely met the criteria for a class A recommendation. Future efforts should be made to develop, evaluate, and implement new systems based on innovative approaches such as intensity or complexity of care.</p></div><div><h3>Implications for Clinical Practice</h3><p>The results facilitate decision making as it establishes a ranking of which instruments are recommended, promising or not recommended to measure the nursing workload in the intensive care units.</p></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":null,"pages":null},"PeriodicalIF":4.9000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0964339724000521/pdfft?md5=d08730da9e672d1746a88d80e7750900&pid=1-s2.0-S0964339724000521-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Intensive and Critical Care Nursing","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0964339724000521","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

To establish an evidence-based recommendation on the use of validated scoring systems that measure nursing workload in relation to the complexity of care in adult Intensive Care Units.

Methods

A systematic review based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) was conducted (PROSPERO registration: CRD42021251272). We searched for validation studies until July 2023 using the bibliographic databases CINAHL, Scopus, Pubmed, WOS, Cochrane Database, SCIELO, Cuiden and Cuidatge. Reference selection and data extraction was performed by two independent reviewers. The assessment of risk of bias was performed using QUADAS-2 and the overall quality according to COSMIN and GRADE approach.

Results

We included 22 articles identifying 10 different scoring systems. Reliability, criterion validity and hypothesis testing were the most frequently measurement properties reported. The NAS was the only tool to demonstrate a Class A recommendation (the best performing instrument).

Conclusions

NAS is the best currently available scoring system to assess complexity of care from nursing workload in ICU. However, it barely met the criteria for a class A recommendation. Future efforts should be made to develop, evaluate, and implement new systems based on innovative approaches such as intensity or complexity of care.

Implications for Clinical Practice

The results facilitate decision making as it establishes a ranking of which instruments are recommended, promising or not recommended to measure the nursing workload in the intensive care units.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

基于重症监护病房护理工作量的护理复杂性测量工具：系统综述。

目的根据成人重症监护病房护理工作的复杂程度，建立以证据为基础的推荐使用有效评分系统：根据基于共识的健康测量工具选择标准（COSMIN）（PROSPERO 注册：CRD42021251272）进行了系统性回顾。我们使用文献数据库 CINAHL、Scopus、Pubmed、WOS、Cochrane 数据库、SCIELO、Cuiden 和 Cuidatge 搜索了 2023 年 7 月之前的验证研究。参考文献的选择和数据提取由两名独立审稿人完成。采用QUADAS-2评估偏倚风险，并根据COSMIN和GRADE方法评估总体质量：我们共纳入了 22 篇文章，确定了 10 种不同的评分系统。可靠性、标准有效性和假设检验是最常报告的测量属性。NAS 是唯一获得 A 级推荐的工具（性能最佳的工具）：NAS是目前可用来评估重症监护室护理工作量中护理复杂性的最佳评分系统。结论：NAS 是目前可用来评估重症监护病房护理工作量复杂性的最佳评分系统，但勉强达到了 A 级推荐标准。今后应努力开发、评估和实施基于护理强度或复杂性等创新方法的新系统：研究结果有助于决策制定，因为它确定了衡量重症监护病房护理工作量的推荐、有前途或不推荐工具的等级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Intensive and Critical Care Nursing NURSING-

CiteScore

6.30

自引率

15.10%

发文量

144

审稿时长

57 days

期刊介绍： The aims of Intensive and Critical Care Nursing are to promote excellence of care of critically ill patients by specialist nurses and their professional colleagues; to provide an international and interdisciplinary forum for the publication, dissemination and exchange of research findings, experience and ideas; to develop and enhance the knowledge, skills, attitudes and creative thinking essential to good critical care nursing practice. The journal publishes reviews, updates and feature articles in addition to original papers and significant preliminary communications. Articles may deal with any part of practice including relevant clinical, research, educational, psychological and technological aspects.