Comparison of nursing workload in a Pediatric Intensive Care Unit estimated by three instruments.

Kelly Dayane Stochero Velozo,Caroline Abud Drumond Costa,Gabriela Rupp Hanzen Andrades,Francielly Crestani,Cristian Tedesco Tonial,Pedro Celiny Ramos Garcia

doi:10.1590/1980-220x-reeusp-2020-0547

Abstract

To compare the nursing workload using the Nursing Activities Score (NAS), Therapeutic Intervention Scoring System-28 (TISS-28) and Nine Equivalents of Nursing Manpower Use Score (NEMS) instruments in children admitted to a Pediatric Intensive Care Unit in a university hospital. A prospective cohort study performed in a Pediatric Intensive Care Unit, with a sample formed of all children hospitalized during the study period. Nursing workload was evaluated using the TISS-28, NEMS and NAS instruments, and further divided into two groups: Group 1 forming a category of basic activities items and Group 2 forming a category of other support and intervention activities. The sample consisted of 490 Pediatric Intensive Care Unit admissions, totaling 4617 observations. NAS presented the best estimate of total working hours. TISS-28 and NEMS showed better agreement and the results showed strong correlations between NAS and TISS-28 and between NEMS and TISS-28. In Group 1 (basic activities), NAS(1) and TISS-28(1) showed moderate correlation, in Group 2 (specialized activities) the three instruments showed strong correlations. NAS stood out in the evaluation of nursing workload and showed good correlation and agreement with the TISS-28.

Highlights

Pediatric Intensive Care Units (PICUs) are intended for children hospitalized with potentially serious illnesses and compromised physiological systems, who require intensive support and treatment, and specialized continuous professional care
To compare the nursing workload using the Nursing Activities Score (NAS),Therapeutic Intervention Scoring System-28 (TISS-28) and Nine Equivalents of Nursing Manpower Use Score (NEMS) instruments in children admitted to a Pediatric Intensive Care Unit in a university hospital
TISS-28 and NEMS showed better agreement and the results showed strong correlations between NAS and TISS-28 and between NEMS and TISS-28

Summary

Introduction

Pediatric Intensive Care Units (PICUs) are intended for children hospitalized with potentially serious illnesses and compromised physiological systems, who require intensive support and treatment, and specialized continuous professional care. Among them is the Therapeutic Intervention Scoring System-28 (TISS-28)(2) and two other instruments derived from it, the Nine Equivalents of Nursing Manpower Use Score (NEMS)(3) and Nursing Activities Score (NAS)(4). The instruments TISS-28 and NEMS measure the patients’ therapeutic needs and relate them to the severity of their condition, while in addition to these measurements, the instrument NAS assesses the care activities performed, regardless of severity[5,6]. These three instruments can be used to estimate nursing workload. The items making up these indicators can be grouped into seven categories, corresponding to basic activities, ventilator, cardiovascular, renal, neurologic and metabolic support, and specific interventions

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Discussion

Conclusion