[Nursing demand in intensive therapy units].

Anestezjologia intensywna terapia Pub Date : 2010-04-01
Edyta K Cudak, Danuta Dyk
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Abstract

Background: The cost of nursing in a modern hospital can take up to 50% of the total budget. Therefore, it is very important to use objective tools for assessment of the nursing workload and adjust staff requirements accordingly. The purpose of the study was to evaluate nursing workload using the Nursing Activities Score (NAS) in intensive care units.

Methods: This prospective analysis of nursing care of 314 adult patients was performed simultaneously in five intensive care units in Poland. NAS was used for the evaluation of nursing workload and the APACHE II score was used for assessment of the severity of cases. The APACHE score was calculated during the first 24 hours of ICU stay, while the NAS was recorded over an entire stay.

Results: The average age of the patients was 58.4 +/- 16.6 years. The length of stay was 8.7 +/- 11.4 days. The distribution between surgical (56%) and non-surgical cases (44%) was almost equal. Mortality was 21%. The median APACHE II score was 20 (1-42) and the NAS score 84.4%. There was no correlation between patients' clinical condition and nursing workload (p > 0.05), and the workload in surgical and non-surgical patients. The NAS score correlated well with the length of stay (p < 0.05).

Conclusion: The study showed that ICU nurses spend 84.4% of their working time by the patient's bed. The optimal ICU nurse: patient ratio was estimated to be 1:1.2.

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[重症监护室护理需求]。
背景:现代医院的护理费用可占总预算的50%。因此,使用客观的工具来评估护理工作量,并据此调整工作人员的要求是非常重要的。本研究的目的是使用护理活动评分(NAS)评估重症监护病房的护理工作量。方法:对波兰5个重症监护病房314名成年患者的护理进行前瞻性分析。采用NAS评估护理工作量,采用APACHE II评分评估病例严重程度。APACHE评分是在ICU住院的前24小时内计算的,而NAS评分是在整个住院期间记录的。结果:患者平均年龄58.4±16.6岁。住院时间为8.7±11.4天。手术病例(56%)和非手术病例(44%)的分布几乎相等。死亡率为21%。APACHE II评分中位数为20 (1-42),NAS评分为84.4%。患者的临床状况与护理工作量无相关性(p > 0.05),手术和非手术患者的护理工作量无相关性(p > 0.05)。NAS评分与住院时间相关(p < 0.05)。结论:研究表明ICU护士有84.4%的工作时间是在患者床边度过的。估计ICU最佳护患比为1:2 .2。
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