Alda Ferreira Queijo

Nursing Activities Score (NAS): adaptação transcultural e validação para a língua portuguesa

El estudio tuvo como objetivos adaptar al portugues y evaluar las propiedades psicometricas de el Nursing Activities Score (NAS), un instrumento para medir la carga de trabajo de enfermeria en UCI. Tras el proceso de adaptacion cultural, el NAS se aplico a una muestra de 200 pacientes adultos ingresados en las UCIs. El analisis de consistencia interna por el coeficiente alfa de Cronbach revelo que el NAS cuenta con 23 medidas independientes que no permiten consolidacion o reduccion. La evaluacion de la fiabilidad interobservador mostro alta concordancia (99,8%) y el indice Kappa media de 0,99. La validez concurrente se demostro por la correlacion estadisticamente significativa entre el TISS-28 y NAS (r=0,67, p<0,0001), y por analisis de regresion multivariante (R2=94,4%, p<0,0001). Al evaluar la validez convergente, la regresion multivariante mostro asociacion estadisticamente significativa entre el NAS y el SAPS II, cuando ajustada por la edad (R2=99,8%, p<0,0001). Los resultados obtenidos indican que el NAS es un instrumento valido y fiable para medir la carga de trabajo de enfermeria de UCIs brasilenas.The study aimed to adapt to the Portuguese language and to evaluate the psychometric properties of the Nursing Activities Score (NAS), an instrument for measuring the nursing workload in ICUs. After the process of cross-cultural adaptation, the NAS was applied to a sample of 200 adult ICU patients. The analysis of internal consistency by Cronbachs alpha coefficient revealed that the NAS has 23 independent measures that do not allow for either consolidation or reduction. Assessment of inter-rater reliability showed high concordance level (99.8%) and a Kappa index average of 0.99. The concurrent validity was demonstrated by statistically significant correlation between the TISS-28 and NAS (r=0.67, p<0.0001), and by multivariate regression analysis (R²=94.4%, p<0.0001). The convergent validity was supported by the statistically significant association between the NAS and the SAPS II, when adjusted for age (R²=99.8%, p<0.0001). These results indicate that the NAS is a valid and reliable instrument to measure nursing workload of Brazilian ICUs.

Nursing Activities Score (NAS): cross-cultural adaptation and validation to Portuguese language

El estudio tuvo como objetivos adaptar al portugues y evaluar las propiedades psicometricas de el Nursing Activities Score (NAS), un instrumento para medir la carga de trabajo de enfermeria en UCI. Tras el proceso de adaptacion cultural, el NAS se aplico a una muestra de 200 pacientes adultos ingresados en las UCIs. El analisis de consistencia interna por el coeficiente alfa de Cronbach revelo que el NAS cuenta con 23 medidas independientes que no permiten consolidacion o reduccion. La evaluacion de la fiabilidad interobservador mostro alta concordancia (99,8%) y el indice Kappa media de 0,99. La validez concurrente se demostro por la correlacion estadisticamente significativa entre el TISS-28 y NAS (r=0,67, p<0,0001), y por analisis de regresion multivariante (R2=94,4%, p<0,0001). Al evaluar la validez convergente, la regresion multivariante mostro asociacion estadisticamente significativa entre el NAS y el SAPS II, cuando ajustada por la edad (R2=99,8%, p<0,0001). Los resultados obtenidos indican que el NAS es un instrumento valido y fiable para medir la carga de trabajo de enfermeria de UCIs brasilenas.The study aimed to adapt to the Portuguese language and to evaluate the psychometric properties of the Nursing Activities Score (NAS), an instrument for measuring the nursing workload in ICUs. After the process of cross-cultural adaptation, the NAS was applied to a sample of 200 adult ICU patients. The analysis of internal consistency by Cronbachs alpha coefficient revealed that the NAS has 23 independent measures that do not allow for either consolidation or reduction. Assessment of inter-rater reliability showed high concordance level (99.8%) and a Kappa index average of 0.99. The concurrent validity was demonstrated by statistically significant correlation between the TISS-28 and NAS (r=0.67, p<0.0001), and by multivariate regression analysis (R²=94.4%, p<0.0001). The convergent validity was supported by the statistically significant association between the NAS and the SAPS II, when adjusted for age (R²=99.8%, p<0.0001). These results indicate that the NAS is a valid and reliable instrument to measure nursing workload of Brazilian ICUs.

Nursing workload in neurological intensive care units: Cross-sectional study

BACKGROUND Nursing workload has been associated with quality of patient care. Thus, it is important to measure nursing workload in neurological intensive care units (neuro-ICUs). OBJECTIVE The aims of the study were to assess nursing workload in neuro-ICUs and identify independent factors associated with nursing workload. METHOD This descriptive, cross-sectional study was conducted in two neuro-ICUs with 11 beds each (for a total of 22 beds) of a private general hospital in the city of São Paulo, Brazil. Data from the first 24 hours of admission to the neuro-ICUs from 100 consecutive patients were collected from the hospital database. The Nursing Activities Score (NAS) was used to assess nursing workload in the neuro-ICUs. Data were analysed using descriptive and inferential statistics and multiple linear regression analysis. Statistical significance was set at α=0.05. RESULTS Patients were mostly men (52.00%), had a mean age of 55.10 years, median length of ICU stay of 2 days, and survival rate of 94.00%. Fifty-nine percent of patients were transferred from the surgical ward. Mean NAS was 65.18% (standard deviation=6.63%) and the risk of mortality according to the Simplified Acute Physiology Score (SAPS II) and the Logistic Organ Dysfunction System (LODS) was 17.79% and 16.30%, respectively. CONCLUSION The present results are important for the effective planning and use of nursing resources according to the care needs of patients in neuro-ICUs.

Carga de trabalho de enfermagem em unidade de terapia intensiva de cardiologia e fatores clínicos associados

O estudo objetivou identificar a carga de trabalho de enfermagem em unidade de Terapia Intensiva de Cardiologia e verificar a associacao dessa variavel com caracteristicas demograficas e clinicas dos pacientes. A amostra foi de 100 pacientes internados no periodo de agosto a setembro de 2006, na Unidade de Terapia Intensiva Cardiologica de um hospital privado, do Municipio de Sao Paulo. O Nursing Activities Score, o Symplified Acute Physiologic ScoreII e o Logistic Organ Disfunction System foram utilizados para medir a carga de trabalho de enfermagem, a gravidade e a disfuncao orgânica, respectivamente. A carga de trabalho de enfermagem foi de 66,60%, equivalente a 5,30 horas de trabalho, em um turno de oito horas. A excecao do tempo de permanencia na Unidade de Terapia Intensiva, que apresentou moderada correlacao com a carga de trabalho, nao houve associacao com as demais variaveis analisadas. Recomenda-se a ampliacao da amostra para conclusoes generalizaveis.The objective of this study was to identify the nursing workload in the Cardiac Intensive Care Unit and to verify the association of this variable according to demographic and clinical patient’s characteristics. The sample consisted of 100 patients hospitalized between August and September of 2006 in a Cardiac Intensive Care Unit of a private hospital in Sao Paulo, Brazil. The Nursing Activities Score, Simplified Acute Physiologic Score II, and the Logistic Organ Dysfunction System were used to measure the nursing workload, severity, and organic dysfunction, respectively. The nursing workload was 66.60% which is equivalent to 5.30 work hours during an eight hour shift. Except for the length of stay in the Intensive Care Unit, which showed a moderate correlation with the workload, there was no association with the other analyzed variables. An expansion of the sample to provide generalized conclusions is highly recommended. DESCRIPTORS: Workload. Intensive care units. Cardiology. Nursing. LAS CARGAS DE TRABAJO DE ENFERMERIA EN LA UNIDAD DE CUIDADOS INTENSIVOS DE CARDIOLOGIA Y LOS FACTORES CLINICOS ASOCIADOS RESUMEN: El estudio tuvo como objetivo identificar la carga de trabajo de enfermeria en la Unidad de Cuidados Intensivos de Cardiologia y verificar la asociacion de esta variable con caracteristicas demograficas y clinicas de los pacientes. La muestra consistio en cien pacientes hospitalizados entre agosto y septiembre de 2006, en la Unidad de Cuidados Intensivos de Cardiologia de un hospital privado de Sao Paulo. El Nursing Activities Score, Symplified Acute Physiologic ScoreII y Logistic Organ Disfunction System se utilizaron para medir la carga de trabajo de enfermeria, la gravedad y disfuncion organica, respectivamente. La carga de trabajo de enfermeria fue del 66,60%, equivalente a 5,30 horas de trabajo en un turno de ocho horas. Excepto por el tiempo pasado en la Unidad de Cuidados Intensivos que mostro una correlacion moderada con la carga de trabajo, no hubo asociacion con las otras variables. Se recomienda ampliar la muestra para conclusiones generalizadas. DESCRIPTORES: Carga de trabajo. Unidades de terapia intensiva. Cardiologia. Enfermeria. 735

Nursing workload in a cardiac intensive care unit and associated clinical factors

O estudo objetivou identificar a carga de trabalho de enfermagem em unidade de Terapia Intensiva de Cardiologia e verificar a associacao dessa variavel com caracteristicas demograficas e clinicas dos pacientes. A amostra foi de 100 pacientes internados no periodo de agosto a setembro de 2006, na Unidade de Terapia Intensiva Cardiologica de um hospital privado, do Municipio de Sao Paulo. O Nursing Activities Score, o Symplified Acute Physiologic ScoreII e o Logistic Organ Disfunction System foram utilizados para medir a carga de trabalho de enfermagem, a gravidade e a disfuncao orgânica, respectivamente. A carga de trabalho de enfermagem foi de 66,60%, equivalente a 5,30 horas de trabalho, em um turno de oito horas. A excecao do tempo de permanencia na Unidade de Terapia Intensiva, que apresentou moderada correlacao com a carga de trabalho, nao houve associacao com as demais variaveis analisadas. Recomenda-se a ampliacao da amostra para conclusoes generalizaveis.The objective of this study was to identify the nursing workload in the Cardiac Intensive Care Unit and to verify the association of this variable according to demographic and clinical patient’s characteristics. The sample consisted of 100 patients hospitalized between August and September of 2006 in a Cardiac Intensive Care Unit of a private hospital in Sao Paulo, Brazil. The Nursing Activities Score, Simplified Acute Physiologic Score II, and the Logistic Organ Dysfunction System were used to measure the nursing workload, severity, and organic dysfunction, respectively. The nursing workload was 66.60% which is equivalent to 5.30 work hours during an eight hour shift. Except for the length of stay in the Intensive Care Unit, which showed a moderate correlation with the workload, there was no association with the other analyzed variables. An expansion of the sample to provide generalized conclusions is highly recommended. DESCRIPTORS: Workload. Intensive care units. Cardiology. Nursing. LAS CARGAS DE TRABAJO DE ENFERMERIA EN LA UNIDAD DE CUIDADOS INTENSIVOS DE CARDIOLOGIA Y LOS FACTORES CLINICOS ASOCIADOS RESUMEN: El estudio tuvo como objetivo identificar la carga de trabajo de enfermeria en la Unidad de Cuidados Intensivos de Cardiologia y verificar la asociacion de esta variable con caracteristicas demograficas y clinicas de los pacientes. La muestra consistio en cien pacientes hospitalizados entre agosto y septiembre de 2006, en la Unidad de Cuidados Intensivos de Cardiologia de un hospital privado de Sao Paulo. El Nursing Activities Score, Symplified Acute Physiologic ScoreII y Logistic Organ Disfunction System se utilizaron para medir la carga de trabajo de enfermeria, la gravedad y disfuncion organica, respectivamente. La carga de trabajo de enfermeria fue del 66,60%, equivalente a 5,30 horas de trabajo en un turno de ocho horas. Excepto por el tiempo pasado en la Unidad de Cuidados Intensivos que mostro una correlacion moderada con la carga de trabajo, no hubo asociacion con las otras variables. Se recomienda ampliar la muestra para conclusiones generalizadas. DESCRIPTORES: Carga de trabajo. Unidades de terapia intensiva. Cardiologia. Enfermeria. 735

Las cargas de trabajo de enfermería en la unidad de cuidados intensivos de cardiología y los factores clínicos asociados

O estudo objetivou identificar a carga de trabalho de enfermagem em unidade de Terapia Intensiva de Cardiologia e verificar a associacao dessa variavel com caracteristicas demograficas e clinicas dos pacientes. A amostra foi de 100 pacientes internados no periodo de agosto a setembro de 2006, na Unidade de Terapia Intensiva Cardiologica de um hospital privado, do Municipio de Sao Paulo. O Nursing Activities Score, o Symplified Acute Physiologic ScoreII e o Logistic Organ Disfunction System foram utilizados para medir a carga de trabalho de enfermagem, a gravidade e a disfuncao orgânica, respectivamente. A carga de trabalho de enfermagem foi de 66,60%, equivalente a 5,30 horas de trabalho, em um turno de oito horas. A excecao do tempo de permanencia na Unidade de Terapia Intensiva, que apresentou moderada correlacao com a carga de trabalho, nao houve associacao com as demais variaveis analisadas. Recomenda-se a ampliacao da amostra para conclusoes generalizaveis.The objective of this study was to identify the nursing workload in the Cardiac Intensive Care Unit and to verify the association of this variable according to demographic and clinical patient’s characteristics. The sample consisted of 100 patients hospitalized between August and September of 2006 in a Cardiac Intensive Care Unit of a private hospital in Sao Paulo, Brazil. The Nursing Activities Score, Simplified Acute Physiologic Score II, and the Logistic Organ Dysfunction System were used to measure the nursing workload, severity, and organic dysfunction, respectively. The nursing workload was 66.60% which is equivalent to 5.30 work hours during an eight hour shift. Except for the length of stay in the Intensive Care Unit, which showed a moderate correlation with the workload, there was no association with the other analyzed variables. An expansion of the sample to provide generalized conclusions is highly recommended. DESCRIPTORS: Workload. Intensive care units. Cardiology. Nursing. LAS CARGAS DE TRABAJO DE ENFERMERIA EN LA UNIDAD DE CUIDADOS INTENSIVOS DE CARDIOLOGIA Y LOS FACTORES CLINICOS ASOCIADOS RESUMEN: El estudio tuvo como objetivo identificar la carga de trabajo de enfermeria en la Unidad de Cuidados Intensivos de Cardiologia y verificar la asociacion de esta variable con caracteristicas demograficas y clinicas de los pacientes. La muestra consistio en cien pacientes hospitalizados entre agosto y septiembre de 2006, en la Unidad de Cuidados Intensivos de Cardiologia de un hospital privado de Sao Paulo. El Nursing Activities Score, Symplified Acute Physiologic ScoreII y Logistic Organ Disfunction System se utilizaron para medir la carga de trabajo de enfermeria, la gravedad y disfuncion organica, respectivamente. La carga de trabajo de enfermeria fue del 66,60%, equivalente a 5,30 horas de trabajo en un turno de ocho horas. Excepto por el tiempo pasado en la Unidad de Cuidados Intensivos que mostro una correlacion moderada con la carga de trabajo, no hubo asociacion con las otras variables. Se recomienda ampliar la muestra para conclusiones generalizadas. DESCRIPTORES: Carga de trabajo. Unidades de terapia intensiva. Cardiologia. Enfermeria. 735

Nursing Activities Score (NAS): adaptación transcultural y validación para el portugués

El estudio tuvo como objetivos adaptar al portugues y evaluar las propiedades psicometricas de el Nursing Activities Score (NAS), un instrumento para medir la carga de trabajo de enfermeria en UCI. Tras el proceso de adaptacion cultural, el NAS se aplico a una muestra de 200 pacientes adultos ingresados en las UCIs. El analisis de consistencia interna por el coeficiente alfa de Cronbach revelo que el NAS cuenta con 23 medidas independientes que no permiten consolidacion o reduccion. La evaluacion de la fiabilidad interobservador mostro alta concordancia (99,8%) y el indice Kappa media de 0,99. La validez concurrente se demostro por la correlacion estadisticamente significativa entre el TISS-28 y NAS (r=0,67, p<0,0001), y por analisis de regresion multivariante (R2=94,4%, p<0,0001). Al evaluar la validez convergente, la regresion multivariante mostro asociacion estadisticamente significativa entre el NAS y el SAPS II, cuando ajustada por la edad (R2=99,8%, p<0,0001). Los resultados obtenidos indican que el NAS es un instrumento valido y fiable para medir la carga de trabajo de enfermeria de UCIs brasilenas.The study aimed to adapt to the Portuguese language and to evaluate the psychometric properties of the Nursing Activities Score (NAS), an instrument for measuring the nursing workload in ICUs. After the process of cross-cultural adaptation, the NAS was applied to a sample of 200 adult ICU patients. The analysis of internal consistency by Cronbachs alpha coefficient revealed that the NAS has 23 independent measures that do not allow for either consolidation or reduction. Assessment of inter-rater reliability showed high concordance level (99.8%) and a Kappa index average of 0.99. The concurrent validity was demonstrated by statistically significant correlation between the TISS-28 and NAS (r=0.67, p<0.0001), and by multivariate regression analysis (R²=94.4%, p<0.0001). The convergent validity was supported by the statistically significant association between the NAS and the SAPS II, when adjusted for age (R²=99.8%, p<0.0001). These results indicate that the NAS is a valid and reliable instrument to measure nursing workload of Brazilian ICUs.