Hi everyone,
ICU nursing staffing's impact on patient (and other) outcomes is well documented in the literature. Nonetheless, methods (e.g. Nursing activities score) have been criticized during the last decade for not including several aspects of the nurse's work besides bedside duties.
Currently, which would be the most valid approach /tool to objectively estimate nursing staffing?
Dear Cristobal Please have a look at these articles.
Article Measuring the nursing workload per shift in the ICU
Article Assessment of Nursing Workload as a Mortality Predictor in I...
Article Measuring the nursing workload in intensive care with the Nu...
I must say that I don´t know any score that includes information about activities not related to direct care to patients. For example: here in Colombia, nurses must review the emergency cart weekly, even if it has not been opened along the last week. They need to fill a lot of forms during the shift, some of them not related directly with patients. (Condition of devices as glucometers, etc). IN many hospitals it can´t be delegated to support personnel as technical nurses.
In addition to this, the activities of the clinical nurse depend, in some ways, on the delivery model and the roles of nurses and support personnel, based on the selected model. When the clinical nurses don´t have a nurse manager in the service, and believe me, here in Colombia we have cases like this, they must be "managers" and clinical nurses at the same time and the workload is really different.
Then, if you get information about new instruments, scales or somethintg similar to measure workload of nurses that includes these activities, please, let me know. One of my students is reasearching about it. PS: Sorry, because my English is not the best.
I would suggest having a look at the following article. Nursing care hours or PCH is widely used and accepted
Article Effect of nursing care hours on the outcomes of Intensive Ca...
Article Assessment of Nursing Workload as a Mortality Predictor in I...
Article Association Between Nursing Workload and Mortality of Intens...
Nursing task , standard time for each task and number of task performed by a nurse with relation of shift time and number of patients
Hello, Sir my Name Chanchal Lata from India. I am interested in your project.
Thank you
Hello
I am DR priyanka chaudhary
I am intersested in your project
Hello
I am DR priyanka chaudhary
I am intersested in your project
Cristobal,
it depends on what you are most interested in. There are scores and ways for assessing workload in bedside nursing that accounts for physical and cognitive workload. Look at work by Heather Tubbs-Cooley. Also, make sure you are looking at the right measures. As I’m sure you know, tools to assess staffing models are not the same as nursing workload. I have partnered with nurse scientists at Emory to look at a combination of metrics, but it also depends on the question you are asking. Hope this helps. Feel free to DM me if you want to discuss further
Michael Fundora, thanks for your reply. It makes a lot of sense to me. I think one of the big questions is if a nursing workload measure such as NAS is capable of reasonable determination of staffing in light of the several non-accounted factors and limitations of those tools.
Another relevant question (in my opinion of course) is the validity of these tools in settings different from which they were developed. Nursing education, roles, and activities are different in Europe, North America, and of course Latin America.
Happy to keep discussing this very relevant topic with you.
Kind regards.
Cristobal Padilla Fortunatti I completely agree. I would think that these tools would need to be validated in settings outside of North America considering the different environment and expectations of nursing. In my opinion, tools are ok but what we all try to aspire to is getting as close to a direct measure of workload as possible.
I’m not sure what you mean by NAS to determine staffing. I think it helps me to take a step back and think about the bigger picture. The way I think about it is that workload is the amount of “work” distributed over hospital resources. NAS measures work, staffing is the hospital resource. You want to get a good measure of work so you can design a better staffing model to address it.
Do you have a specific research question in mind?
With NAS, as well as other nursing workload tools (e.g. TISS -28), an overall score can be calculated and translated to a certain number of nurses required to meet the patient's care needs.
However, my concerns are related to the NAS validity when it comes to determining a specific number of ICU nurses. Since it was developed in 2003, I am looking for a similar tool that accounts for NAS limitations (at least some of them).
The NAS is being referred to in terms of workload in the ICU. Please read the article below
DOI: 10.1016/j.iccn.2018.06.005.