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Using Nursing Activities Score to Assess Nursing Workload on a Medium Care Unit
Elizabeth Armstrong1, Monique C de Waard, Harm-Jan S de Grooth
1From the *Department of Intensive Care, VU University Medical Centre, Amsterdam, The Netherlands; †Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands; and ‡Department of Intensive Care, University Hospital Groningen, Groningen, The Netherlands.
Anesthesia and Analgesia
|October 21, 2015
Summary
The Nursing Activities Score (NAS) reveals higher nursing workload in medium care units (MCUs) during day and evening shifts compared to night shifts. Patient admission source impacts workload, with emergency admissions showing higher NAS, comparable to intensive care unit (ICU) levels.
Area of Science:
- Nursing workload assessment
- Healthcare management
- Patient care environments
Background:
- Medium care units (MCUs) are crucial for patients needing higher inpatient care but not full intensive care.
- Optimal nurse-to-patient ratios in MCUs remain undefined and may vary by shift.
- The Nursing Activities Score (NAS), used in ICUs, has not been applied to MCUs.
Purpose of the Study:
- To measure nursing workload in an MCU using the NAS per 8-hour shift.
- To compare MCU NAS with that of an intensive care unit (ICU).
- To analyze NAS variations based on patient admission sources within the MCU.
Main Methods:
- Prospective measurement of NAS per patient per shift over 2 months.
- Study conducted in a 9-bed tertiary referral university hospital MCU.
- Concurrent NAS measurement in the hospital's ICU for comparison.
Main Results:
- Mean NAS was higher during day and evening shifts than night shifts in the MCU.
- MCU NAS was comparable to ICU NAS, with no significant difference during evening shifts.
- Patients admitted from the accident and emergency department had a significantly higher NAS than those from other sources.
Conclusions:
- Nursing workload in the MCU varies by shift, peaking during day and evening hours.
- Patient origin significantly influences MCU nursing workload, with emergency admissions being most demanding.
- The NAS is a valuable tool for MCU managers to assess staffing needs and understand workload variations.
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