Cardiac surgery intensive care unit nursing workload assessment using Nursing Activities Score

Abstract

Introduction/Objective. Nursing Activities Score (NAS) is one of the most accepted and widely used scores for assessing the workload of the nursing staff in regards of qualitative and quantitative adequacy. The aim of this study was to evaluate and analyze nursing workload in the cardiac surgery intensive care unit (CSICU) using the NAS in a contemporary set of patients undergoing heart surgery. Methods. The study included 809 consecutive patients who had a major cardiac surgery in 2019 admitted to adult CSICU. Demographic data were collected from medical records [sex, age, type of treatment, length of stay (LOS), and discharge], EuroSCORE II, and NAS value. Results. The majority of patients underwent a coronary (43.1%), valvular (32.6%), and combined (24.2%) cardiac surgery procedure. The average patient LOS in CSICU was 2.5 ± 3.4 days. The average NAS value in our sample was 100.8% ± 63.1%. NAS value during the first operative day was a poor marker of the outcome in terms of mortality (C-index 0.520, 95% CI – 0.422–0.617, p = 0.676). Significant difference was observed in terms of average NAS value between the patients submitted to coronary surgery and combined surgery (p = 0.001). NAS has been shown to be useful for assessing activity in a CSICU, confirming the optimal workload of nurses, while higher NAS values in our hospital indicate increased workload compared to similar institutions. Conclusion. NAS provided viable information regarding the care and hospitalization of patients in a CSICU. In accordance with NAS, the optimal level of nursing workload was established in our hospital settings.

Keywords

• intensive care unit
• nursing workload
• cardiac surgery
• length of stay