Abstract
Objective Measure nursing workload required by patients submitted to autologous and allogeneic hematopoietic stem cell transplantation (HSCT) and analyze the Nursing Activities Score (NAS) of the nursing team during the hospitalization period for HSCT. Method A prospective cohort study conducted from January 2013 to April 2014 with 62 patients hospitalized in the HSCT unit of a university hospital in Campinas, São Paulo, Brazil. The workload was measured through NAS and data analysis was through chi-square test or Fisher's exact test, Mann-Whitney test and Spearman's correlation coefficient; with 5% significance level. Results Mean nursing workload was 67.3% (SD of 8.2) in autologous HSCT patients and 72.4% (SD of 13.0) in allogeneic HSCT patients (p=0.1380).Monitoring and titration showed, in more than 50% of the time, patients demanded intensified care, requiring two hours or more in a nursing shift for reasons of safety, severity or therapy. Conclusion The nursing workload and the NAS items with the highest scores reflect the magnitude, complexity and specificity of care required by patients submitted to HSCT.
Highlights
Evidence of the nursing team’s influence on quality of care and the safety of patients are well documented[1,2], with excessive workload being one of the factors that contribute to negative outcomes, especially in extremely ill patients[3,4].A study conducted in an intensive care unit (ICU) showed an association between high workload and increased mortality, with 7% increase in the risk of death for every additional patient per nurse[3]
The Nursing Activities Score (NAS) is a useful instrument to measure the nursing workload, that is, the time spent by a nursing professional to provide patient care[6,7]
This study presented the prevalence of male patients (53.2%) and allogeneic hematopoietic stem cell transplantation (HSCT) (61.3%)
Summary
A study conducted in an intensive care unit (ICU) showed an association between high workload and increased mortality, with 7% increase in the risk of death for every additional patient per nurse[3]. A review of nursing workload shows that this indicator is usually defined in terms of nurse-to-patient staffing ratios[2]. To show the actual work dimension, the staffing ratios require other complementary tools that include, in such measurement, the care needs based on a patient’s medical condition. In this perspective, the Nursing Activities Score (NAS) is a useful instrument to measure the nursing workload, that is, the time spent by a nursing professional to provide patient care[6,7]
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