[Nursing Activity Score (NAS). Our experience with a nursing load calculation system based on times]. / Nursing Activity Score (NAS). Nuestra experiencia con un sistema de cómputo de cargas de enfermería basado en tiempos.

INTRODUCTION: The load calculation systems of nursing work in the ICU has not had the same success in its introduction as the prognostic survival estimation systems. It causes may be: a medical design not oriented towards nursing (Therapeutic Intervention Scoring System--TISS in all its versions), lack of adaptation to the calculating of staff (Nursing Manpower Use Score--NEMS, care levels) and demand for permanent technological up-dating. In 2003, NAS was published in an attempt to obviate all the problems expressed. Its result expresses the percentage of nursing work time required for attention to each patient. Our objective has been to apply the method in our ICU and evaluate its results. PATIENTS AND METHODS: During the last quarter of 2004, NAS was systematically applied to all the patients admitted to our ICU, regardless of the reason for admission and stay time in the Unit. The analysis of this application was done by SPSS/PC 11. RESULTS: NAS calculations of 350 patients, which represents 1880 total registers, were collected during the mentioned period. The NAS result of the first day was analyzed, 40.8 +/- 14.1, comparing it with its evolution during all the stay days of each patient, until reaching the ICU discharge date (39.3 +/- 12.7). The mean stay of our series has been 4.3 +/- 5.4 days during this period and the total accumulated NAS per patient was 196.2 +/- 279.8. There was no good correlation (R2: 0.273) between the NAS score on the first day of stay in the ICU but there was between total NAS and total stay of each case (R2: 0.958). Translated into times, this implies that one nurse can care for (by shift and average) 2.5 patients in our ICU. CONCLUSIONS: This system adapts, without demands of periodic up-dating, to the real nursing work in the ICU. Its design is oriented to nursing work, regardless of the disease that justifies admission to the ICU. It is useful to adequately evaluate the nursing staff in the conventional ICU.

Nursing Activity Score (NAS). Nuestra experiencia con un sistema de cómputo de cargas de enfermería basado en tiempos / Nursing Activity Score (NAS). Our experience with a nursing load calculation system based on times

Introducción: Los sistemas de cómputo de cargas de trabajo de enfermería en unidad de cuidados intensivos (UCI) no han gozado del mismo éxito, en su implantación, que los sistemas de estimación pronóstica de supervivencia. Las causas de ello pueden ser: un diseño médico no orientado a enfermería (Therapeutic Intervention Scoring System [TISS] en todas sus versiones), una falta de adaptación al cálculo de plantillas (nine equivalents of nursing manpower use score [NEMS], niveles de asistencia) y una exigencia de permanente actualización tecnológica. En 2003, se publica el Nursing Activity Score (NAS), en un intento de obviar todos los problemas expresados y cuyo resultado expresa el porcentaje de tiempo de trabajo de enfermería que requiere la atención de cada paciente. Nuestro objetivo ha sido aplicar el método en nuestra UCI y evaluar sus resultados. Pacientes y métodos: Durante el último trimestre de 2004 se aplicó el NAS sistemáticamente a todos los pacientes ingresados en nuestra UCI, con independencia del motivo de ingreso y el tiempo de estancia en la unidad. El análisis de esta aplicación se ha realizado mediante SPSS/PC 11. Resultados: Se han recogido, durante el período citado, cómputos de NAS de 350 pacientes, lo que representa 1.880 registros totales. Se ha analizado el resultado de NAS del primer día 40,8 ± 14,1 y se ha comparado con su evolución durante todos los días de estancia de cada paciente, hasta alcanzar el día de alta de la UCI (39,3 ± 12,7). La estancia media de nuestra serie ha sido durante este período de 4,3 ± 5,4 días, y el NAS acumulado total por paciente de 196,2 ± 279,8. No existió buena correlación (R2 = 0,273) entre la puntuación NAS del primer día de estancia en UCI, y sí la hubo entre NAS total y estancia total de cada caso (R2 = 0,958). Traducido en tiempos, esto implica que una enfermera puede atender (por turno y promedio) en nuestra UCI a 2,5 pacientes. Conclusiones: Este sistema se adapta, sin exigencias de actualización periódica, al trabajo real de la enfermería en UCI, su diseño esta orientado al trabajo de enfermería, con independencia de la patología que justifica el ingreso en UCI y es útil para evaluar, adecuadamente, la plantilla de enfermería en una UCI convencional

Introduction: The load calculation systems of nursing work in the ICU has not had the same success in its introduction as the prognostic survival estimation systems. It causes may be: a medical design not oriented towards nursing (Therapeutic Intervention Scoring System - TISS in all its versions), lack of adaptation to the calculatin of staff (Nursing Manpower Use Score - NEMS, care levels) and demand for permanent technological up-dating. In 2003, NAS was published in an attempt to obviate all the problems expressed. Its result expresses the percentage of nursing work time required for attention to each patient. Our objective has been to apply the method in our ICU and evaluate its results. Patients and Methods: During the last quarter of 2004, NAS was systematically applied to all the patients admitted to our ICU, regardless of the reason for admissin and stay time in the Unit. The analysis of this application was done by SPSS/PC 11. Results: NAS calculations of 350 patients, which represents 1880 total registers, were collected during the mentioned period. The NAS result of the first day was analyzed, 40.8 ± 14.1, comparing it with its evolution during all the stay days of each patient, until reaching the ICU discharge date (39.3 ± 12.7). The mean stay of our series has been 4.3 ± 5.4 days during this period and the total accumulated NAS per patient was 196.2 ± 279.8. There was no good correlation (R2: 0.273) between the NAS score on the first day of stay in the ICU but there was between total NAS and total stay of each case (R2: 0.958). Translated into times, this implies that one nurse can care for (by shift and average) 2.5 patients in our ICU. Conclusions: This system adapts, without demans of periodic up-dating, to the real nursing work in the ICU. Its design is oriented to nursing work, regardless of the disease that justifies admission to the ICU. It is useful to adequately evaluate the nursing staff in the conventional ICU