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[Care work load in critical patients. Comparative study NEMS versus NAS]
Amparo Bernat Adell1, Ricardo Abizanda Campos, María Yvars Bou
1Diplomados en Enfermería, Servicio de Medicina Intensiva, Hospital Universitario Asociado General de Castellón, Castellón, Spain. bernat_mar@gva.es
Enfermeria Intensiva
|June 24, 2006
Summary
This study found the Nursing Activity Score (NAS) better reflects ICU patient care loads than the Nine Equivalents of Nurse Manpower use score (NEMS). The two systems showed poor correlation, indicating NAS is a more suitable tool for calculating nursing workload.
Area of Science:
- Nursing Informatics
- Healthcare Management
- Critical Care Medicine
Background:
- Current patient care load calculation systems lack widespread adoption due to design flaws and complexity.
- Existing methods like TISS-76 and simpler scores (NEMS) are not nurse-centric, hindering accurate staff allocation.
- The Nursing Activity Score (NAS) was developed to address these limitations in measuring nursing workload.
Purpose of the Study:
- To evaluate the correlation between the Nine Equivalents of Nurse Manpower use score (NEMS) and the Nursing Activity Score (NAS).
- To determine the suitability of NEMS and NAS in reflecting actual patient care demands in the ICU.
- To compare the calculation methodologies and value ranges of NEMS and NAS.
Main Methods:
- Simultaneous application of NEMS and NAS by ICU nursing staff over a three-month period in 2004.
- Collection of 150 daily and 150 shift-based NEMS-NAS value pairs for analysis.
- Statistical comparison including means, linear correlation, histogram analysis, value ranges, and bias coefficients using SPSS/PC 11.
Main Results:
- NEMS demonstrated a significantly narrower value range (18-45) compared to NAS (29.70-84.50 daily; 22.40-84.50 per shift).
- Linear correlation analysis revealed weak correlations: R² of 0.1634 for shift values and R² of 0.2012 for daily values.
- NEMS results are in points, while NAS is expressed as a percentage of time dedicated to patient care, highlighting a methodological difference.
Conclusions:
- NAS appears better adapted to quantifying the real-time care demands of ICU patients compared to NEMS.
- The study concludes that NEMS and NAS are not interchangeable due to their poor correlation and differing measurement approaches.
- NAS is recommended as a more accurate tool for assessing nursing workload in the ICU setting.
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