48
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Correlação entre carga de trabalho de enfermagem e gravidade dos pacientes críticos gerais, neurológicos e cardiológicos Translated title: Correlation between work load of nursing and severity of critical general, neurological and cardiac patients Translated title: Correlación entre carga de trabajo en enfermería y severidad de los pacientes críticos generales, neurológicos y cardiológicos

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objetivo: Correlacionar gravidade do paciente e carga de trabalho da equipe de enfermagem, utilizando os índices Simplified Acute Psysiology Score (SAPS3) e Nursing Activities Score (NAS) e compará-los entre três subgrupos: cardiológicos, neurológicos e gerais. Métodos: Coorte prospectivo, em uma Unidade de Terapia Intensiva de hospital privado de São Paulo, entre agosto a outubro de 2011. Resultados: Foram acompanhados 195 pacientes, 57,9% do sexo masculino, mediana de idade 69 anos. Correlação moderada entre NAS e SAPS3 no subgrupo neurológico (p = 0,02; r = 0,430). SAPS3 do subgrupo geral foi maior comparado ao subgrupo neurológico (p = 0,002). O NAS foi maior no subgrupo geral quando comparado ao subgrupo cardiológico (p = 0,001). Conclusão: Houve correlação moderada entre a gravidade de pacientes neurológicos e a carga de trabalho de enfermagem. A gravidade e a carga de trabalho de enfermagem no subgrupo de pacientes gerais foram maiores em relação aos pacientes neurológicos e cardiológicos, respectivamente.

          Translated abstract

          Objective: To correlate severity of the patient and the nursing staff workload, using Simplified Acute Physiology Score (SAPS3) and Nursing Activities Score (NAS) indexes and comparing them between three subgroups: cardiac, neurological and general. Methods: Prospective cohort study, in an Intensive Care Unit of a private hospital in São Paulo, from August to October 2011. Results: There were 195 patients, 57.9% male, median age 69 years old. Moderate correlation between NAS and SAPS3 neurological subgroup (p = 0.02, r = 0.430). SAPS3 the general subgroup was higher compared to neurological subgroup (p = 0.002). The NAS is generally greater when compared to cardiac subgroup (p = 0.001). Conclusion: There was a moderate correlation between the severity of neurological patients and the nursing workload. The severity and nursing workload in the subgroup of general patients were higher in relation to neurological and cardiac patients, respectively.

          Translated abstract

          Objetivo: Correlacionar gravedad del paciente y carga de trabajo del equipo de enfermería, utilizando los índices Simplified Acute Psysiology Score (SAPS3) y Nursing Activities Score (NAS) en tres subgrupos: cardíacos, neurológicos y generales. Métodos: Cohorte prospectivo realizado en una Unidad de Cuidados Intensivos de un hospital privado de São Paulo, agosto a octubre de 2011. Resultados: Participaron 195 pacientes, 57,9% hombres, edad media 69 años. Correlación moderada entre NAS y SAPS3 subgrupo neurológico (p = 0,02, r = 0,430). SAPS3 el subconjunto general fue mayor en comparación con neurológico (p = 0,002). El NAS es generalmente mayor cuando se compara con el subgrupo cardíaco (p = 0,001). Conclusión: Correlación moderada entre la gravedad de pacientes neurológicos y la carga de trabajo de los enfermeros. La gravedad y la carga de trabajo en el subgrupo de pacientes generales eran más altas en relación con pacientes neurológicos y cardíacos, respectivamente.

          Related collections

          Most cited references37

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          Nursing Workload as a Risk Factor for Healthcare Associated Infections in ICU: A Prospective Study

          Introduction Nurse understaffing is frequently hypothesized as a potential risk factor for healthcare-associated infections (HAI). This study aimed to evaluate the role of nursing workload in the occurrence of HAI, using Nursing Activities Score (NAS). Methods This prospective cohort study enrolled all patients admitted to 3 Medical ICUs and one step-down unit during 3 months (2009). Patients were followed-up until HAI, discharge or death. Information was obtained from direct daily observation of medical and nursing rounds, chart review and monitoring of laboratory system. Nursing workload was determined using NAS. Non-compliance to the nurses’ patient care plans (NPC) was identified. Demographic data, clinical severity, invasive procedures, hospital interventions, and the occurrence of other adverse events were also recorded. Patients who developed HAI were compared with those who did not. Results 195 patients were included and 43 (22%) developed HAI: 16 pneumonia, 12 urinary-tract, 8 bloodstream, 2 surgical site, 2 other respiratory infections and 3 other. Average NAS and average proportion of non compliance with NPC were significantly higher in HAI patients. They were also more likely to suffer other adverse events. Only excessive nursing workload (OR: 11.41; p: 0.019) and severity of patient’s clinical condition (OR: 1.13; p: 0.015) remained as risk factors to HAI. Conclusions Excessive nursing workload was the main risk factor for HAI, when evaluated together with other invasive devices except mechanical ventilation. To our knowledge, this study is the first to evaluate prospectively the nursing workload as a potential risk factor for HAI, using NAS.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Nine variations and a coda on the theme of an evolutionary definition of dysfunction.

            K. Fulford (1999)
            Nine variations on the theme of J. C. Wakefield's (1999) evolutionary definition of dysfunction show that the concept is not, as he claims, purely causal. It depends also on a teleological element of meaning introduced, in Wakefield's formulation, through an equivocation on the sense in which natural selection explains biological forms. The corollary (presented here briefly as a coda to the theme and variations) is that Wakefield's definition is not, as he also claims, value free. However, contra S. O. Lilienfeld and L. Marino (1995), this does not place diagnostic judgments of dysfunction outside the scope of science.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              Aplicabilidade do escore fisiológico agudo simplificado (SAPS 3) em hospitais brasileiros

              JUSTIFICATIVA E OBJETIVOS: O sistema prognóstico SAPS 3 (Simplified Acute Physiology Score 3) é composto de 20 variáveis, representadas por escore fisiológico agudo e avaliação do estado prévio, visando estabelecer índice preditivo de mortalidade para pacientes admitidos em unidades de terapia intensiva (UTI). O estudo teve objetivo de validar este sistema e verificar o poder discriminatório deste índice em pacientes cirúrgicos do Brasil. MÉTODO: Estudo prospectivo, realizado em duas UTI especializadas em pacientes cirúrgicos de dois diferentes hospitais, no período de um ano, excluiuse pacientes com idade inferior a 16 anos, que permaneceram tempo inferior a 24 horas na UTI, readmitidos e aqueles admitidos para procedimento dialítico. A habilidade preditiva do índice SAPS 3 em diferenciar sobreviventes e não sobreviventes foi verificada utilizando curva ROC e a calibração pelo teste Hosmer-Lemeshow goodness-of-fit. RESULTADOS: Foram incluídos no estudo 1.310 pacientes. Operações gastrintestinais foram predominantes (34,9%). O menor valor do índice SAPS 3 foi 18 e o maior 154, média de 48,5 ± 18,1. A mortalidade hospitalar prevista e real foi de 10,3% e de 10,8%, respectivamente, razão de mortalidade padronizada (SMR) foi 1,04 (IC95% = 1,03-1,07). A calibração pelo método Hosmer e Lemeshow mostrou X² = 10,47 p = 0,234. O valor do escore SAPS 3 que melhor discriminou sobreviventes e não sobreviventes foi 57, com sensibilidade de 75,8% e especificidade de 86%. Dos pacientes com índice SAPS 3 maior que 57, 73,5% não sobreviveram versus 26,5% de sobreviventes (OR = 1,32 IC95% 1,23 - 1,42, p < 0,0001). CONCLUSÕES: O sistema SAPS 3 é válido na população brasileira de pacientes cirúrgicos, sendo útil para indicar pacientes graves e determinar maiores cuidados neste grupo.
                Bookmark

                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                ean
                Escola Anna Nery
                Esc. Anna Nery
                Universidade Federal do Rio de Janeiro (Rio de Janeiro )
                2177-9465
                June 2015
                : 19
                : 2
                : 233-238
                Affiliations
                [1 ] Hospital Sírio-Libanês Brazil
                [2 ] Universidade Federal de São Paulo Brazil
                Article
                S1414-81452015000200233
                10.5935/1414-8145.20150030
                cf34aaa5-9a95-4d4a-8b77-6c05c9965619

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1414-8145&lng=en
                Categories
                NURSING

                Nursing
                Severity of illness index,Workload,Nursing,Intensive care units,Índice de severidad de la enfermedad,Carga de trabajo,Enfermería,Unidades de cuidados intensivos,Índice de gravidade de doença,Carga de trabalho,Enfermagem,Unidades de terapia intensiva

                Comments

                Comment on this article