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Published on: January 16, 2019

Measuring care complexity: a retrospective cross-sectional observational study - CardioMEO PediCARE (Ancona, Italy)

Alessia Galli1, Ludovica Mazzieri2, Chiara Gatti3

  • 1Emergency Department, Department of Emergency, AOU delle Marche, Ancona, Italy.

Igiene E Sanita Pubblica
|June 12, 2026
PubMed

Insights

Pediatric cardiovascular patients

Area of Science:

  • Pediatric cardiovascular nursing
  • Healthcare management
  • Patient acuity assessment

Background:

  • Global nursing shortages necessitate reliable tools for measuring pediatric patient care complexity.
  • Pediatric cardiovascular units face high patient acuity and cognitive nursing workload demands.
  • Validated tools for assessing pediatric care complexity are limited.

Purpose of the Study:

  • To measure nursing care complexity in pediatric cardiovascular patients.
  • To identify clinical and organizational factors associated with higher complexity levels.
  • To utilize validated pediatric acuity tools for assessment.

Main Methods:

  • Retrospective cross-sectional observational study of 313 patient records (January-December 2022).
  • Utilized CAMEO II and Inpatient CAMEO tools to assess nursing care complexity.
  • Employed chi-square tests and linear regression analyses to identify predictors of complexity.

Main Results:

  • Intensive care unit patients exhibited medium nursing care complexity.
  • Inpatient cardiac unit: 27% low, 73% medium complexity; no high complexity.
  • Younger age, urgent admission, and longer hospital stay predicted higher complexity.
  • Organizational factors like day of week and shift were not significant predictors.
  • The model explained 46% of the variance in baseline complexity scores.

Conclusions:

  • Patient-related clinical factors, not organizational ones, drive nursing care complexity in pediatric cardiovascular settings.
  • Younger, urgently admitted patients with longer stays require higher cognitive nursing workload.
  • Validated acuity tools (CAMEO II, Inpatient CAMEO) support evidence-based workforce planning and optimize nurse-to-patient ratios.
  • Findings aid decision-making in specialized pediatric settings amid healthcare resource constraints.
Abstract

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