The assessment of nursing workload offers both support for patient care planning and service management. In an Intensive Care Unit (ICU) this workload is measured by the Nursing Activities Scores (NAS), although in specialized areas such as Cardiology, its use is still diminished. Objective: To describe NAS and the prevalence of its sub-items in a Brazilian Cardiac ICU. We also aimed to evaluate NAS oscillation since the opening of the unit, and according to the day of the week. Methods: Daily NAS records collected from November 2014 to October 2018 were assessed, totaling 8600 assessments distributed over 49 months. The data were analyzed according to time, day of the week, number of records per day, and dichotomizing if NAS was higher or lower than 50 points. Results: NAS presented mean value of 52.91 points and a median of 53.40 points. The mean NAS values per month ranged from 45.00 to 59.10 points. The percentage of NAS assessments above 50 points ranged from 20.59 to 92.34% per month and proved to be a better indicator for assessing the variability of the monthly workload. When combined two by two, 66.01% of NAS combinations scored more than 100 points, suggesting the need for more than one nursing professional per day. When the data were stratified by year, 2018 had the lowest means compared to the others. When compared to the mean values in function of the day of the week, it was observed that Monday to Friday (with the highest mean on Wednesday, the predominant day for cardiac surgeries) showed higher values than weekends. Conclusions: Overall, NAS showed low values compared to other general or cardiac ICUs, it also presented temporal variability and our results showed risk of workload overload which can compromise patient care and safety. Such results reinforce the importance of the administrative and assistant aspects of the routine use of NAS in ICUs specially in specialized environments as Cardiac ICU.

The intensive care unit (ICU) requires a specialized team with adequate human resources, including nursing. For an adequate measurement of the workload of nursing professionals of Brazilian ICUs, the Nursing Activities Score (NAS) has been used to promote better adequacy of work scales. Work overload can increase the incidence of adverse events, including healthcare-associated infections (HAI). Objective: To associate the nursing workload measured by the NAS with the rates of HAI in an Adult ICU of a university hospital, in addition to evaluating the impact of the separation of ICUs by unit, or type of specialization. Method: Data collection was performed at Brazil, in the Adult ICU: stratified by the Surgical, Neurological and Medical specialties; including the calculation of the means of NAS and the monthly rates of HAI of each ICU unit, from 2016 to April 2019. NAS data were collected from secondary spreadsheets, without identification of the patient, and the rates of HAIs were collected from information from the Hospital Infection Control Service. Results: The mean NAS was different for each unit, with Neurological unit with the highest mean. In relation to HAIs, neurological unit patients had a higher incidence of HAIs and patients with HAIs. Pneumonia associated with mechanical ventilation (VAP) was higher in Surgical and Neurological units. Bloodstream and urinary tract infection were higher in the Medical unit. There was a positive correlation for NAS and VAP in the Medical unit and with urinary tract infection in the Surgical unit. In the Neurological unit there was a negative correlation with the rate of HAI and rate of patients with HAI. Conclusion: The mean NAS observed by us was lower when compared to other ICUs and variations may be associated with the type of hospital and clinical profile of patients. It was possible to observe that each unit has its particularity regarding the incidence of HAIs and the association between NAS (nursing workload) and rates, reinforcing the need for stratification and association of indicators per unit.

Objetivo: Identificar o diagnóstico de enfermagem prioritário no paciente pós-infarto do miocárdio com supradesnivelamento do segmento ST. Métodos: Estudo observacional, longitudinal, prospectivo, realizado com 54 pacientes de ambos os sexos, admitidos na fase aguda do infarto durante os primeiros cinco dias pós-infarto (D1 a D5), em um hospital de ensino. Amostragem foi não probabilística. Para a coleta de dados, utilizou-se um instrumento estruturado a partir do modelo teórico conceitual das Necessidades Humanas Básicas. Empregaram-se análises descritivas e bivariadas. Resultados: O diagnóstico de enfermagem de maior incidência no D1 pós-infarto foi Debito cardíaco diminuído, seguido por padrão respiratório ineficaz e dor aguda. O diagnóstico de enfermagem Débito Cardíaco Diminuído foi associado aos indivíduos não brancos (p<0,05). Conclusão: Observou-se a prevalência do diagnóstico de enfermagem prioritário de débito cardíaco diminuído nos cinco primeiros dias pós-infarto.