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Nurse Staffing Levels: Skill Mix and Nursing Care Hours Per Patient Day

  • Alberto Lucchini
  • Michele Pirovano
  • Christian De Felippis
  • Irene Comisso
Chapter

Abstract

There is evidence that nursing workload is associated with the quality of patient care and the health of workers. Workloads and resource allocation can be measured by scoring systems. To provide a real-time assessment of nurse allocation and workloads, the Nursing Activities Score (NAS) was developed as a means to measure patient care. The items examine specific activities: patient monitoring, medication, hygiene procedures, care of drains, patient mobilization and positioning, admission and discharge procedures, administrative and managerial tasks, research activity and renal, invasive and non invasive ventilation, cardiovascular, metabolic and nutritional support. There is also the possibility to weigh those specific interventions in intensive care which are the exclusive competence of nurses. The authors maintain that the score wholly reflects 81% of nursing time. The remaining 19% comes from nursing activities deriving from medical interventions, related exclusively to the severity of illness of the patient. NAS was created in order to better define nursing activities in relation to continuous patient monitoring, performing hygiene procedures, mobilization procedures, data handling and caring for relatives. The appropriate application of NAS will support the taking up of real measures in response to the working demands of nurses and will allow for improved investment in human and material resources at the ICU.

Keywords

Nursing workload NAS Staffing ICU 

Abbreviations

A&E

Accident & emergency department

CICU

Cardiosurgical intensive care unit

GICU

General intensive care unit

MICU

Medical intensive care unit

N/P

Nurse-to-patient ratio

NAS

Nursing activities score

NICU

Neurosurgical general intensive care unit

PICU

Pediatric intensive care unit

SAPS

Simplified acute physiology score

SOFA

Sequential organ dysfunction score

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Alberto Lucchini
    • 1
  • Michele Pirovano
    • 2
  • Christian De Felippis
    • 3
  • Irene Comisso
    • 4
  1. 1.General Intensive Care UnitSan Gerardo Hospital, ASST Monza, University of Milano-BicoccaMilanItaly
  2. 2.AREU Regional Emergency System-ITMilanItaly
  3. 3.Adult Intensive Care Unit, Glenfield HospitalUniversity Hospital of Leicester-NHS TrustLeicesterUK
  4. 4.University Anesthesia and Intensive Care Unit, University Hospital S. Maria della MisericordiaUdineItaly

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