[No Title Available]

Queijo, Alda Ferreira; Padilha, Kátia Grillo

doi:10.1590/s0080-62342009000500004

Cited by 53 publications

(65 citation statements)

References 16 publications

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“…Delirium was assessed by the internal medicine resident on charge twice daily using Confusion Assessment Method for ICU (CAM-ICU) [14], also on the first seven days or until ICU discharge. Nurse workload was evaluated daily until day 5 with the Portuguese version of Nursing Activity Score (NAS) in morning shifts [15]. Total sequentialorgan failure assessment (SOFA) scores were also calculated daily until day 5 [16].…”

Section: Methodsmentioning

confidence: 99%

Daily sedative interruption versus intermittent sedation in mechanically ventilated critically ill patients: a randomized trial

Nassar

Park

2014

Ann Intensive Care

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BackgroundDaily sedative interruption and intermittent sedation are effective in abbreviating the time on mechanical ventilation. Whether one is superior to the other has not yet been determined. Our aim was to compare daily interruption and intermittent sedation during the mechanical ventilation period in a low nurse staffing ICU.MethodsAdult patients expected to need mechanical ventilation for more than 24 hours were randomly assigned, in a single center, either to daily interruption of continuous sedative and opioid infusion or to intermittent sedation. In both cases, our goal was to maintain a Sedation Agitation Scale (SAS) level of 3 or 4; that is patients should be calm, easily arousable or awakened with verbal stimuli or gentle shaking. Primary outcome was ventilator-free days in 28 days. Secondary outcomes were ICU and hospital mortality, incidence of delirium, nurse workload, self-extubation and psychological distress six months after ICU discharge.ResultsA total of 60 patients were included. There were no differences in the ventilator-free days in 28 days between daily interruption and intermittent sedation (median: 24 versus 25 days, P = 0.160). There were also no differences in ICU mortality (40 versus 23.3%, P = 0.165), hospital mortality (43.3 versus 30%, P = 0.284), incidence of delirium (30 versus 40%, P = 0.472), self-extubation (3.3 versus 6.7%, P = 0.514), and psychological stress six months after ICU discharge. Also, the nurse workload was not different between groups, but it was reduced on day 5 compared to day 1 in both groups (Nurse Activity Score (NAS) in the intermittent sedation group was 54 on day 1 versus 39 on day 5, P < 0.001; NAS in daily interruption group was 53 on day 1 versus 38 on day 5, P < 0.001). Fentanyl and midazolam total dosages per patient were higher in the daily interruption group. The tidal volume was higher in the intermittent sedation group during the first five days of ICU stay.ConclusionsThere was no difference in the number of ventilator-free days in 28 days between both groups. Intermittent sedation was associated with lower sedative and opioid doses.Trial registrationClinicalTrials.gov Identifier: NCT00824239.

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Section: Methodsmentioning

confidence: 99%

Daily sedative interruption versus intermittent sedation in mechanically ventilated critically ill patients: a randomized trial

Nassar

Park

2014

Ann Intensive Care

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“…The nursing workload was assessed by the Nursing Activities Score (NAS), and the risk of pressure injury was by the Braden scale, both instruments having been previously translated and validated in Brazilian Portuguese (Paranhos & Santos, 1999;Queijo & Padilha, 2009). Regarding the application of NAS, an inter-rater reliability test was performed between ICU nurses of the included hospitals and researchers, in a sample of 116 patients from different ICU units.…”

Section: Data Collectionmentioning

confidence: 99%

Pressure injuries in critical patients: Incidence, patient-associated factors, and nursing workload

et al. 2018

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Aim:To estimate the incidence of pressure injury and its predictors including nursing workload in critical patients. Background:There is controversy about the influence of the nursing workload on the occurrence of pressure injury in intensive care units. Methods:A retrospective cohort of 766 patients in nine intensive care units of two university hospitals was studied. The nursing workload was measured using the Nursing Activities Score. The predictors were identified by logistic regression. Results:The pressure injury incidence was 18.7%. The odds ratio of the development of pressure injury, increased 3.5 times in mechanical ventilation (p < 0.001), 7.8 times in palliative care (p = 0.004), 2.3 times in the 60-84 years old group (p = 0.005); it also increased 10% for each day of hospitalization (p < 0.001), and 1.5% for each registered point of the Nursing Activities Score (p = 0.016). Conclusion:Existing risks for the development of pressure injury have been confirmed and nursing workload identified as a new predictor. Much still needs to be done in the area of prevention, especially in groups at risk. Implications for Nursing Management:Increasing nursing resources in the intensive care unit may assist in reducing the pressure injury rate. K E Y W O R D Sincidence, intensive care units, nursing, pressure ulcer, workload | 309 STRAZZIERI-PULIDO ET AL.

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“…The NAS, translated and validated for the Brazilian culture by Queijo,9 measures the nursing workload in ICU, in terms of the proportion of the time spent on direct and indirect care in the previous 24 hours. At the time of writing, this instrument is being used in 12 different countries and studies have related its use to variables such as patient mortality, length of stay, and the occurrence of adverse events.…”

Section: 7-10mentioning

confidence: 99%

“…At the time of writing, this instrument is being used in 12 different countries and studies have related its use to variables such as patient mortality, length of stay, and the occurrence of adverse events. 3,9,11,12 Using this instrument to measure the nursing workload promotes the practicing of safe care and reduces costs for the institution. 7,10,11 Accordingly, the nurses must analyze the dynamics and specific characteristics of the ICU where they work, as well as the characteristics of the patients, in order to apply the tools and strategies for organizing the activities and the nursing work process.…”

Section: 7-10mentioning

confidence: 99%

Nursing Activities Score by assistance sites in Intensive Care Units

et al. 2017

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Objective: To compare the Nursing Activities Score (NAS) between the Assistance Sites in an Intensive Care Unit. Method:Descriptive, retrospective study, carried out in the Intensive Care Unit of a teaching hospital. The patients were organized in Assistance Sites according to their clinical characteristics and the nursing team's composition was organized in accordance with the Nursing Activities Score (NAS). The confidence interval was set at p < 0.05. Results: the majority were male surgical patients with a mean age of 56.8 years. The postoperative care Site presented the greatest patient turnover. The overall average NAS was 71.7%. There was a difference in the nursing workload between the different Assistance Sites. The shorter length of stay and the nonsurvivors contributed to increasing the workload in the ICU. Conclusion: Comparing the NAS in the differentSites made it possible to organize the work process of the nursing team according to each group, contributing to patient safety. Estudio descriptivo, retrospectivo, realizado en la Unidad de Cuidados Intensivos de un hospital escuela. Los pacientes fueron organizados en Sitios Asistenciales según sus características clínicas y el dimensionamiento de los profesionales de enfermería fue realizado según el NAS. Se consideró p < 0,05. Resultados: Predominaron pacientes del sexo masculino, quirúrgicos y con edad media de 56,8 años. El Sitio post-operatorio presentó mayor rotación de pacientes. El NAS medio global fue el 71,7%. Se verificó diferencia de la carga de trabajo de enfermería entre los diferentes Sitios Asistenciales. El menor tiempo de internación y los pacientes no sobrevivientes contribuyeron con el aumento de la carga de trabajo en la UCI. Conclusión: Fue posible organizar el proceso de trabajo del equipo de enfermería de acuerdo con cada grupo, contribuyendo con la seguridad del paciente. Keywords

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[No Title Available]

Cited by 53 publications

References 16 publications

Daily sedative interruption versus intermittent sedation in mechanically ventilated critically ill patients: a randomized trial

Daily sedative interruption versus intermittent sedation in mechanically ventilated critically ill patients: a randomized trial

Pressure injuries in critical patients: Incidence, patient-associated factors, and nursing workload

Nursing Activities Score by assistance sites in Intensive Care Units

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