Comparison of Trendcare and the Nursing Activities Score to measure critical care nursing workload: a cross-sectional correlation design
Authors List
Mary Corkery, Alison Pirret, Kathleen Devoy, Andrew Gilhooly
Middlemore Hospital, Auckland New Zealand
Introduction: Lower nurse:patient ratios improve quality of care and patient, family and nursing staff satisfaction. With an international shortage of nurses combined with increased critical care demand, accurate measurement of nursing workload is needed. Internationally the Nursing Activities Score (NAS) is the most widely used scoring system to measure critical care nursing workload.
Aim: To determine: 1) if Trendcare accurately reflects the intensive care (ICU) and high dependency care (HDU) nursing workload as measured by the NAS.
Method: Using a cross-sectional correlational design, data were collected between 9 August and 25th November 2021. Nursing workload was assessed at 6am, 2pm and 10pm using Trendcare and the NAS. Trendcare shift data were obtained from the Trendcare data base. An online form was used to collect NAS data. The NAS scores were applied to the collected data during analysis. Ethics no. (AH2120).
Data analysis: Data of 183 patients and 806 Trendcare and corresponding NAS scores were analysed. In the ICU group Trendcare allocated more nursing hours than the NAS for each 8- hour shift (Day: Trendcare Mdn=10.0 hrs [IQR=10.0-16.0], NAS Mdn=5.2 hrs [IQR=4.5-6.3]; Afternoon: Trendcare Mdn=10.0 hrs (IQR=10.0-16.0), NAS Mdn=4.9 hrs (IQR=4.2-6.5); Night Trendcare Mdn=10.0 (10.0-16.0), NAS Mdn=4.9 hrs (4.2-6.1). In the HDU group, the nursing hours allocated by Trendcare and the NAS were more closely aligned (Day: Trendcare Mdn=4.5 hrs [IQR=2.3-5.1], NAS Mdn=3.8 hrs [IQR=3.2-4.8]; Afternoon: Trendcare Mdn=3.4 hrs (IQR=2.3-4.4), NAS Mdn=3.5 hrs (IQR=3.0-4.0); Night: Trendcare Mdn=3.4 (1.3-4.9), NAS Mdn=3.7 hrs (3.2-4.3). Correlation between Trendcare and the NAS was unable to be performed due to bimodal Trendcare data.
Conclusion: When compared to the NAS, Trendcare allocates more nursing hours in the ICU population but is similar to NAS in the HDU population. Trendcare nursing hours based on benchmarked categories prevents correlation to the NAS. The NAS more likely reflects nursing models where a 1:2 nurse:patient ratio for ventilated patients is accepted.
Mary Corkery, Alison Pirret, Kathleen Devoy, Andrew Gilhooly
Middlemore Hospital, Auckland New Zealand
Introduction: Lower nurse:patient ratios improve quality of care and patient, family and nursing staff satisfaction. With an international shortage of nurses combined with increased critical care demand, accurate measurement of nursing workload is needed. Internationally the Nursing Activities Score (NAS) is the most widely used scoring system to measure critical care nursing workload.
Aim: To determine: 1) if Trendcare accurately reflects the intensive care (ICU) and high dependency care (HDU) nursing workload as measured by the NAS.
Method: Using a cross-sectional correlational design, data were collected between 9 August and 25th November 2021. Nursing workload was assessed at 6am, 2pm and 10pm using Trendcare and the NAS. Trendcare shift data were obtained from the Trendcare data base. An online form was used to collect NAS data. The NAS scores were applied to the collected data during analysis. Ethics no. (AH2120).
Data analysis: Data of 183 patients and 806 Trendcare and corresponding NAS scores were analysed. In the ICU group Trendcare allocated more nursing hours than the NAS for each 8- hour shift (Day: Trendcare Mdn=10.0 hrs [IQR=10.0-16.0], NAS Mdn=5.2 hrs [IQR=4.5-6.3]; Afternoon: Trendcare Mdn=10.0 hrs (IQR=10.0-16.0), NAS Mdn=4.9 hrs (IQR=4.2-6.5); Night Trendcare Mdn=10.0 (10.0-16.0), NAS Mdn=4.9 hrs (4.2-6.1). In the HDU group, the nursing hours allocated by Trendcare and the NAS were more closely aligned (Day: Trendcare Mdn=4.5 hrs [IQR=2.3-5.1], NAS Mdn=3.8 hrs [IQR=3.2-4.8]; Afternoon: Trendcare Mdn=3.4 hrs (IQR=2.3-4.4), NAS Mdn=3.5 hrs (IQR=3.0-4.0); Night: Trendcare Mdn=3.4 (1.3-4.9), NAS Mdn=3.7 hrs (3.2-4.3). Correlation between Trendcare and the NAS was unable to be performed due to bimodal Trendcare data.
Conclusion: When compared to the NAS, Trendcare allocates more nursing hours in the ICU population but is similar to NAS in the HDU population. Trendcare nursing hours based on benchmarked categories prevents correlation to the NAS. The NAS more likely reflects nursing models where a 1:2 nurse:patient ratio for ventilated patients is accepted.