Intensive Care Nursing Scoring System Research Articles

Intensive Care Nursing Scoring System in Human Resource Allocation for ICU Nurses Systematic Evaluation

Intensive Care Nursing Scoring System in Human Resource Allocation for ICU Nurses Systematic Evaluation

Application of Intensive Care Nursing Scoring System in Patients with Intracerebral Hemorrhage in ICU

Objective: To explore the clinical value of intensive care nursing scoring system intervention in patients with intracerebral hemorrhage in ICU. Methods: 80 patients with intracerebral hemorrhage in ICU treated in our hospital were selected as the research sample (January 2021 December 2021). The patients were divided into groups according to the double-blind lottery method. The control group carried out routine nursing intervention. The observation group applied the intensive care nursing scoring system on the basis of the control group. The time indexes, quality of life, NIHSS score and ESS score of the two groups were observed, The incidence of complications and satisfaction rate were calculated. Results: each index time (ICU time, mechanical ventilation time and hospitalization time) in the observation group was less than that in the control group (P < 0.05). Before intervention, the scores of quality of life (cognitive function, physical function, social function and emotional function) had no comparative value (P > 0.05); After the intervention, the scores of various indexes in the observation group were higher, and the difference was more obvious than that in the control group (P < 0.05). There was no significant difference in each index (NIHSS score and ESS score) before intervention (P > 0.05). After the intervention, the NIHSS score of the observation group was lower and the ESS score was higher than that of the control group (P < 0.05). The complications in the observation group were 5.00% lower than 17.50% in the control group (P < 0.05). The satisfaction of 97.50% in the observation group was lower than 85.00% in the control group (P < 0.05). Conclusion: the intervention effect of intensive care nursing scoring system for patients with intracerebral hemorrhage in ICU is significant. It can effectively improve the quality of life of patients, reduce the risk of adverse events, shorten the length of hospital stay and improve the satisfaction of patients and their families. It has high clinical practice value and is worthy of promotion.

The proportion of understaffing and increased nursing workload are associated with multiple organ failure: A cross-sectional study.

To determine whether nurse staffing and nursing workload are associated with multiple organ failure and mortality. A cross-sectional study. This study was conducted in a single tertiary-level teaching hospital during 2008-2017. The association between nurse staffing, nursing workload and prognosis was determined using daily nurse-to-patient ratios, Therapeutic Intervention Scoring System scores, Intensive Care Nursing Scoring System scores and Intensive Care Nursing Scoring System indexes. In addition, the timing of intensive care unit admission was considered. Multiple organ failure was defined according to the Sequential Organ Failure Assessment score. During the study period, 10,230 patients were included in the final analysis. Generally, the mean daily highest Therapeutic Intervention Scoring System score and Intensive Care Nursing Scoring System score were significantly higher in patients with multiple organ failure and in non-survivors. The proportion of understaffing was significantly more common in patients with multiple organ failure than in those without. The mean daily lowest nurse-to-patient ratio and the mean daily highest Intensive Care Nursing Scoring System index did not differ between survivors and non-survivors. The levels of nursing associated with workload and understaffing were at their worst on weekends. The proportion of understaffing and increased nursing workload are associated with multiple organ failure, demonstrating that an adequate level of nurse staffing in relation to patient complexity is a prerequisite for the availability and quality of critical care services. The proportion of understaffing did not differ between survivors and non-survivors. This is the first study that evaluates nurse staffing and nursing workload as potential risk factors for multiple organ failure and mortality. There is a need to ensure that intensive care units are consistently staffed based on real patient needs, 7days a week and that personnel and services are available at all times for high-risk patients.

Association of nurse staffing and nursing workload with ventilator-associated pneumonia and mortality: a prospective, single-center cohort study

Nurse understaffing and increased nursing workload have been associated with increased risk of adverse patient outcomes and even mortality. To determine whether nurse staffing and nursing workload are associated with ventilator-associated pneumonia and mortality. This prospective, observational cohort study was conducted in a single tertiary-level teaching hospital in Finland during 2014-2015. The association between nurse staffing, nursing workload and prognosis was determined using daily nurse-to-patient ratios, Therapeutic Intervention Scoring System and Intensive Care Nursing Scoring System scores, and Intensive Care Nursing Scoring System indices. Ventilator-associated pneumonia was defined according to the Centers for Disease Control and Prevention criteria. Evaluable data was available for 85 patients. The overall ventilator-associated pneumonia and 28-day mortality rates were 23.5% and 35.3%, respectively. Nurse staffing, measured as the daily lowest nurse-to-patient ratio (P=0.006) and median Intensive Care Nursing Scoring System index (P=0.046), were significantly lower in patients with ventilator-associated pneumonia. In addition, nursing workload, measured as median scores obtained by the Therapeutic Intervention Scoring System (P=0.009) and Intensive Care Nursing Scoring System (P=0.03), was significantly higher in infected patients. The median (P=0.02) and daily highest (P=0.03) Intensive Care Nursing Scoring System scores were significantly higher in non-survivors. Lower nurse staffing and increased nursing workload are associated with ventilator-associated pneumonia and mortality, demonstrating that adequate staffing is a prerequisite for the availability and quality of critical care services.

Application of hierarchical management system based on ICNSS in traumatic brain injury patients

Objective To explore application effect of hierarchical management based on Intensive Care Nursing Scoring System (ICNSS) in intensive care unit (ICU) patients with brain injury. Methods A total of 65 ICU patients with brain injury from June 2013 to May 2014 were treated as control group; another 60 cases of ICU patients with brain injury from June 2014 to May 2015 were treated as observation group. Patients in the control group were implemented with routine nursing, while the observation group with hierarchical management based on ICNSS system. Prognosis, complications, nurse-patient disputes events, nursing risk events, and patient satisfaction of two groups were compared. Results In observation group, plant survival rate (3.33%), incidence of complications(6.67%), nurse dispute event rate(3.33%), incidence of nursing risk events (5.00%) were lower than those of the control group(χ2=4.296, 4.720, 4.296, 5.354; P<0.05). Among patient satisfaction of the observation group, scores of health education(3.85±0.45)points, medical environment(3.79±0.53)points, psychological nursing(3.65±0.78)points, service attitude(3.38±0.56)points, operational care(3.49±0.29)points were higher than those of the control group (t=40.821, 36.362, 23.801, 24.972, 43.465; P<0.01). Conclusions Based on the ICNSS, hierarchical management model can allocate human resources in ICU reasonably and effectively, improve quality of care for patients with traumatic brain in ICU, reduce the incidence nursing risk events and elevate patient and family satisfaction. Key words: Intensive Care Nursing Scoring System; Intensive care unit; Brain injury; Prognosis; Satisfaction

Influnce of Intensive Care Nursing Scoring System applied in human resource allocation on nursing quality in ICU

Objective To evaluate the effect of Intensive Care Nursing Scoring System （ ICNSS ） applied in human resource allocation on nursing quality in ICU .Methods Totals of 161 cases of ICU patients were admitted in our hospital in 2013.They were divided into the experimental group （85 cases） and the control group （76 cases） according to their admission time.The control group received routine nursing care , while the experimental group used ICNSS system to evaluate the patients ’ condition, and reasonably allocated the nursing resources.The quality of care was compared between the two groups , including basic nursing, critical care, nursing documents, operation skills, disinfection and isolation and complications , nurses’ satisfaction to job, and patient/family satisfaction to nurses .Results The qualified rate of the experimental group in the basic care , critical care, nursing document, operation skills, disinfection were （95.6 ±3.2）,（96.7 ±1.7）,（94.6 ±2.3） and （96.3 ±1.8）, respectively, which were significantly higher than those of the control group （t=4.06, 3.98, 4.32, 5.17, respectively;P〈0.05）.The patient/family satisfaction of the experimental group was 92.3%, which was significantly higher than 79.4%of the control group （χ^2 =4.64,P〈0.05）.Nurses’ satisfaction to the job in the experimental group was 92.7%, which was significantly higher than 62.3%of the control group （χ^2 =5.28,P〈0.05）.Conclusions The application of ICNSS measurement system in ICU can effectively allocate nursing human resource , and improve the quality of nursing care and patient/family satisfaction. Key words: Intensive care; Nursing management research; Nursing assessment system; Nursing quality

The allocation and requirements of ICU nurses in the internal medicine department of National Medical Emergency Rescue Team

Objective To study the allocation and requirements of ICU nurses in the intemal medicine department of National Medical Emergency Rescue Team,and explore more reasonable ICU nurses allocation method.Methods 40 patients were randomly divided into the observation group and the control group with 20 cases in each group.The control group adopted even allocation method,while the observation group allocated nurses according to ICU nursing evaluation system.The nursing effect was compared between two groups.Results ICU nursing score between two groups showed no significant difference,but the ICU indwelling time of the observation group was shorter than that of the control group.Conclusions ICU nurses need higher comprehensive quality.ICU nursing evaluation system can facilitate the allocation of nurses.Better allocation and higher overall qualities of internal medicine ICU nurses can improve ICU treatment efficiency. Key words: Resource allocation; Intensive care nursing scoring system; Nursing management

Investigation of nursing workload and related factors of CCU

Objective To investigate nursing workload and related factors of Coronary Care Unit (CCU),and to provide evidence for rationally arranging nursing human resources and improving nursing efficiency.Methods 77 inpatients of a third-grade class-A hospital were surveyed by means of Intensive Care Nursing Scoring System (ICNSS) to investigate workload of CCU nurses.Results Total score of CCU nursing workload was (25.5714 ± 6.48) points.ICNSS scores of the four seasons were (27.24 ± 4.438 ),( 25.62 ±4.535),(22.33 ±9.403),(27.24 ±6.953 ),respectively,the difference was statistically significant (F =11.867,P ＜0.01 ).The LSD multiple comparison showed that there were significant differences of ICNSS scores between the first quarter and the second quarter,the first quarter and the third quarter,the second quarter and the third quarter,the third quarter and the fourth quarter,the difference was statistically significant (P ＜0.05 ).The workload of the nurses who took care of the patients admitted by means of wheel chair and stretcher was (20.74 ± 4.663 ) and (25.89 ± 6.508 ) points,and the difference was statistically significant ( t =0.319,P ＜0.05 ).There was significant difference of nursing workload regarding length of stay and percutaneous coronary intervention (P ＜ 0.05 ).Among same type of disease,workload of CCU nurses was the highest on admission and on the day of percutaneous coronary intervention.Nursing workload was found negatively correlated with length of stay of the patients ( P ＜ 0.05 ).Of the 36 patients undergone percutaneous coronary intervention,the workload of CCU nurses was (26.35 ± 4.057 ) scores on the day of intervention,(23.58 ±3.525) scores on day 1,( 22.16 ± 4.537 ) scores on day 2 and ( 19.17 ± 3.637 ) points after day3,the difference was statistically significant ( F =21.024,P ＜ 0.05 ).Conclusions A flexible staff arrangement should be adopted according to the characters of the disease,patients' conditions and the nursing workload. Key words: Coronary care unit; Nursing workload; Related factors; Human resource management

Comparative study for the effect of intensive care nursing scoring and APACHE II scoring in care resource allocation of intensive care unit

Objective To compare the value of intensive care nursing scoring system (ICNSS) with acute physiology and chronic health evaluation ( APACHE Ⅱ ) scoring on care resource allocation in intensive care unit(ICU). Methods A total of 108 ICU patients were divided into observation group(n = 55 ) and control group(n = 53) randomly. In the observation group, the ICNSS scale was strictly translated and modified according to chinese practical situation by nurse experts, then applied to evaluate nursing workload and allocate care resource. In the control group,care resource was allocated according to dynamic monitoring of APACHE Ⅱ scoring. The ICU monitoring time, therapy cost, incidence of complications during the hospitalization,satisfaction of the nurses and the patients or their relatives were compared between two groups. Results The ICU monitoring time(4.6 ±2.9) d, therapy cost ￥ (15 678.2 ±6 115.3) and incidence of complications (7.3%) during the hospitalization in the observation group were significantly less than those in the control group ( P ＜ 0. 05), while the satisfaction of the nurses and the patients or their relatives in the observation group was markedly better than that in the control group ( P ＜ 0. 05 ). Conclusions Care resource allocation according to ICNSS can more significantly improve nursing quality, satisfaction of nurses and patients or their relatives than care resource allocation according to APACHE Ⅱ scoring. Key words: Intensive care nursing scoring system; Acute physiology and chronic health evaluation scoring; Resource allocation

Intensive Care Nursing Scoring System Part 2: nursing interventions and nursing outcomes.

Different medical classifications and scoring systems have been developed to measure and compare intensive care outcomes in international contexts. Many of them, however, do not include outcome variables to describe autonomous nursing and its effects on the patient's experiences and restrictions as a result of the onset and process of illness, or relatives' or significant others' distress in the intensive care environment. The Intensive Care Nursing Scoring System (ICNSS) is a new instrument to describe and highlight nurses' work and its effects on the patients and their relatives in a way not allowed by medical classifications and scoring systems. ICNSS can be used to evaluate a single intensive care nursing process from admission to discharge or to compare patients in different intensive care units for certain variables. ICNSS can also be used to measure nurses' workload. The classification of nursing diagnoses was described in a previous article. This paper describes nursing outcomes and nursing interventions as well as the use of ICNSS in a computer-based information management system in three adult intensive care units in the Oulu University Hospital.

Intensive care nursing scoring system. Part 1: Classification of nursing diagnoses.

The introduction of computer-based information management systems to intensive care units offers new possibilities to describe and document the content of nursing. In different countries and health care organizations, the hospital culture and the approach taken by nurses and medical colleagues determine what, how and to what extent nursing is documented. There are nursing diagnosis classifications that are used in North America, such as NANDA (North American Nursing Diagnosis Association), and the European Union Telenurse project will promote the use of the ICNP (International Classifications of Nursing Practice) throughout Europe. The above classifications are used to describe individual, family or community responses to potential or actual health problems or life processes. But there is no nursing diagnosis classification that would take into account both the aims and the unique context of intensive care nursing. This first article describes part of our research: the action research process and the result of the development of a nursing diagnosis classification compatible with the goals of intensive care in three adult intensive care units in the Oulu University Hospital. The classification of nursing diagnoses is part of the Intensive Care Nursing Scoring System (ICNSS) which was developed in the course of this study. The other parts deal with nursing outcomes and nursing interventions. ICNSS is used to facilitate information exchange in the process of intensive care nursing and to describe the nursing workload.