The use of the Nursing Activities Score in clinical settings: an integrative review

Abstract

Objective analyze how studies have approached the results obtained from the application of the Nursing Activities Score (NAS) based on Donabedian's model of healthcare organization and delivery. Method CINAHL and PubMed databases were searched for papers published between 2003 and March 2015. Results 36 articles that met the inclusion criteria were reviewed and double-coded by three independent coders and analyzed based on the three elements of Donabedian's health care quality framework: structure, process and outcome. The most frequently addressed, but not always tested, variables were those that fell into the structure category. Conclusion variables that fell into the process category were used less frequently. Beside NAS, the most frequently used variables in the outcome category were mortality and length of stay. However, no study used a quality framework for healthcare or NAS to evaluate costs, and it is recommended that further research should explore this approach.

Nursing Activities Score by assistance sites in Intensive Care Units

“…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.…”

“…Consequently, they also impact on the work process and on the team's workload. 3,4 Inadequate allocation of human resources is associated with the occurrence of adverse events, patient mortality, and increases in hospital costs. 5 In this regard, one important challenge for the managers of these complex units is the nursing team's adaptation to these patients' care demands.…”

Impact of promoting self-care in nursing workload

“…The assessment of nursing workload has been identified as an important management tool, since it is directly associated to the quality of care, patient safety, optimization of human resources and reduced costs, as it considers the complexity of care and the work process in a given population, contributing to the quantitative and qualitative aspects related to staff (1)(2) . Historically, the staff number is directly related to hospital costs, constantly being targeted when it comes to cost containment.…”

Carga de trabalho de enfermagem relacionada ao índice de massa corporal de pacientes críticos

“…The studies selected for this review included, with a higher frequency, the variables related to the characteristics of patients (age and gender), the clinical conditions (severity of illness, organ dysfunction, risk of mortality, and risk of pressure injury), conditions of the unit (including type of ICU, proportion of nurses/technicians per patient, and occupation rate), and the outcome (mortality and length of stay). In addition, the importance of exploring the use of the NAS with a view to the analysis of the care process, costs management, and care quality (9) was emphasized.…”