[Care work load in critical patients. Comparative study NEMS versus NAS]. / Cargas de trabajo asistencial en pacientes críticos. Estudio comparativo NEMS frente a NAS.

INTRODUCTION: The systems of calculating care load have not yet reached the levels of generalized use which the systems of prognostic estimation of survival have. The reason for this is their potential defects of design (medical and not nursing conceptualization) and the sometimes confusing completion (TISS 76). The simplest ("nine equivalents of nurse manpower use score" [NEMS], care levels) add the difficulty of not being useful for the calculation of staff, because the design is not oriented towards nursing. The development of NAS (nursing activity score) by FRICE tries to solve all these problems. Our objective has been to verify to what degree the NEMS and NAS are correlated as systems of expression and calculation of care load. PATIENTS AND METHOD: During the last quarter of 2004, NEMS and NAS have been used simultaneously by the nursing staff. During this period, 150 pairs of daily calculation values of NEMS-NAS and 150 pairs of calculation values by shift of NEMS-NAS have been collected. Comparison of means and linear correlation of values obtained and the analysis of the histograms of values of each series, their value ranges and analysis of their bias coefficients have been done. The analysis was done with the SPSS/PC 11. RESULTS: During the period indicated, it has been verified that NEMS has a much narrower value range than NAS, both in regards to daily values (18-45 versus 29.70-84.50) and in regards to values by shift (18-45 versus 22.40-84.50). The bias analysis shows a deviation to the left of both series of values. Linear correlation between NEMS-NAS by shift shows a R2 of 0.1634 and becomes even poorer in the NEMS-NAS correlation per day with R2 of 0.2012. It should also be stressed that NEMS expresses its results in points while NAS does so in percentage of time occupied in the attention and care of the patient. CONCLUSIONS: In this preliminary study, the better adaptation of NAS versus NEMS to real work loads of patients hospitalized in the ICU and the non-possible correlation between the values of both systems is affirmed.

Cargas de trabajo asistencial en pacientes críticos. Estudio comparativo NEMS frente a NAS / Care work load in critical patients. Comparative study NEMS versus NAS

Introducción. Los sistemas de cómputo de carga asistencial no han alcanzado aún los niveles de utilización generalizada que poseen los sistemas de estimación pronóstica de supervivencia. La causa de ello son sus potenciales defectos de diseño (conceptualización médica y no de enfermería) y la, a veces, farragosa cumplimentación (TISS 76). Los más simples (NEMS [nine equivalents of nursing manpower use score], niveles de asistencia) añaden la dificultad de no ser útil es para el cálculo de plantillas, debido a un diseño no orientado a enfermería. El desarrollo de NAS (nursing activity score) por FRICE® intenta solventar todos estos problemas. Nuestro objetivo ha sido comprobar en qué medida se correlacionan NEMS y NAS como sistemas de expresión y computo de carga asistencial. Pacientes y método. Durante el último trimestre de 2004 se han utilizado simultáneamente NEMS y NAS, por parte del personal de enfermería. Durante este período se han recogido 150 pares de valores de cómputo diario de NEMS-NAS y 150 pares de valores de cómputo por turno de NEMS-NAS. Se ha realizado la comparación de medias y la correlación lineal de valores obtenidos, así como el análisis de los histogramas de valores de cada serie, sus rangos de valor y el análisis de sus coeficientes de sesgo. El análisis se ha realizado mediante SPSS/PC 11. Resultados. Durante el período señalado se ha constatado que NEMS tiene un rango de valor mucho más estrecho que NAS, tanto en lo que se refiere a valores diarios (18-45 frente a 29,70-84,50) como a valores por turno (18-45 frente a 22,40-84,50). El análisis de sesgo muestra una desviación a la izquierda de ambas series de valores. La correlación lineal entre NEMS-NAS por turno, muestra una R2 de 0,1634, y se empobrece aún más en la correlación NEMS-NAS por día con R2 de 0,0212. Debe destacarse, además, que NEMS expresa sus resultados en puntos, mientras que NAS lo hace en porcentaje de tiempo ocupado en la atención y cuidado del paciente. Conclusiones. En este estudio preliminar se constata la mejor adecuación de NAS frente a NEMS a las reales cargas de trabajo de los pacientes ingresados en UCI y la no posible correlación entre los valores de ambos sistemas

Introduction. The systems of calculating care load have not yet reached the levels of generalized use which the systems of prognostic estimation of survival have. The reason for this is their potential defects of design (medical and not nursing conceptulalization) and the sometimes confusing completion (TISS 76). The simplest («nine equivalents of nurse manpower use score» [NEMS], care levels) add the difficulty of not being useful for the calculation of staff, because the design is not oriented towards nursing. The development of NAS (nursing activity score) by FRICE® tries to solve all these problems. Our objective has been to verify to what degree the NEMS and NAS are correlated as systems of expression and calculation of care load. Patients and method. During the last quarter of 2004, NEMS and NAS have been used simultaneously by the nursing staff. During this period, 150 pairs of daily calculation values of NEMS-NAS and 150 pairs of calculation values by shift of NEMS-NAS have been collected. Comparison of means and linear correlation of values obtained and the analysis of the histograms of values of each series, their value ranges and analysis of their bias coefficients have been done. The analysis was done with the SPSS/PC 11. Results. During the period indicated, it has been verified that NEMS has a much narrower value range than NAS, both in regards to daily values (18-45 versus 29.70-84.50) and in regards to values by shift (18-45 versus 22.40-84.50). The bias analysis shows a deviation to the left of both series of values. Linear correlation between NEMS-NAS by shift shows a R2 of 0.1634 and becomes even poorer in the NEMS-NAS correlation per day with R2 of 0.2012. It should also be stressed that NEMS expresses its results in points while NAS does so in percentage of time occupied in the attention and care of the patient. Conclusions. In this preliminary study, the better adaptation of NAS versus NEMS to real work loads of patients hospitalized in the ICU and the non-possible correlation between the values of both systems is affirmed