Uso do nursing activities score em uma unidade de terapia intensiva coronariana brasileira: uma experiência de quatro anos

Abstract

Introduction: The evaluation of nursing workload offers support for planning of patient care. In Intensive Care Unit environments this workload is measured by the Nursing Activies Scores (NAS) indicator, which have demonstrated important administrative and care applications. This instrument assesses the profile of each patient, with information such as vital signs control, hygiene procedures, respiratory support, dialysis techniques, etc. The sum of obtained points is converted into the number of nursing hours that a patient needs in 24 hours. Objectives: The objective of the study was to describe NAS in a Coronary Intensive Care Unit as a measure of workload, as well as to evaluate its temporal oscillation from the opening of the unit, its oscillation according to the day of the week, and the prevalence of the subitems of the instrument. Material and methods: The daily NAS data collected from 2014 to 2018 were evaluated. Data were tabulated, summarized with descriptive statistics and analyzed with parametric or non-parametric statistics on account of data behavior. Results: NAS presented a mean value of 52.91 and a median of 53.40. The average NAS values per month ranged from 45.00 to 59.10. The percentage of patients above 50 points ranged from 20.59 to 92.34, and was a better indicator for assessing the monthly workload in the unit. When the data were stratified according to the year, 2018 presented the lowest mean values compared to the other years. When compared to the mean values according to the day of the week, it was observed that Monday to Friday showed values higher than the weekends. The most frequently evaluated NAS items were: 1 - vital signs, calculations and regular registry of fluid balance (97.22%); 2 - laboratory investigations (100%); 3 - medication, except vasoactive drugs (99.95%); 4 - hygiene procedures (99.66%); 7 - support and care for relatives and patients for about one hour (99.93%); 8 - performing routine administrative and management tasks (100%); and 17 - quantitative measure of urine output (94.25%). Conclusion: In general, NAS exhibit low values, temporal variability and the results showed work overload, which can compromise patient care.