Model to estimate the nursing workload required by trauma victims on intensive care unit discharge

• Published in: Journal of nursing management Vol. 28; no. 2; pp. 239 - 246
• Main Authors: Nogueira, Lilia de Souza, Sousa, Regina, Nacer, Daiana Terra, Bonfim, Ane Karoline Silva, Fernandes, Lillian Caroline, Sloboda, Dyenily Alessi
• Format: Journal Article
• Language: English
• Published: England Hindawi Limited 01-03-2020
• Subjects: Adult; Brazil; clinical evaluation; Cohort analysis; Cohort Studies; Critical care; Female; Hospitals; Humans; Injuries; Intensive care; intensive care units; Intensive Care Units - organization & administration; Intensive Care Units - statistics & numerical data; Male; Measurement; Middle Aged; Nursing; Nursing administration; Nursing Care - classification; Nursing Care - methods; Patient Discharge - standards; Patient Discharge - statistics & numerical data; Physiology; Prospective Studies; Reliability; Reproducibility of Results; Severity of Illness Index; Simplified Acute Physiology Score; survivors; Trauma; Victims; workload; Workload - classification; Workload - standards; Workloads; wounds and injuries; Wounds and Injuries - nursing; Brazil; wounds and injuries; workload; nursing; clinical evaluation; survivors; intensive care units
• ISSN: 0966-0429; 1365-2834
• DOI: 10.1111/jonm.12912

Aim
To validate a model to estimate the nursing workload required by trauma victims on intensive care unit (ICU) discharge.
Background
Identifying a reliable model of nursing workload measurement that can assist professionals.
Methods
A prospective cohort study conducted in 2010 (first phase) and 2015 (second phase) with 342 trauma victims admitted into the ICU of four hospitals located in São Paulo, Brazil. The original model was created during the first phase and included the Simplified Acute Physiology Score and New Injury Severity Score variables. Coefficients of determination (R2) were calculated to identify the reliability.
Results
The original model presented high reliability (R2 = 44%) in the hospital of origin, and unsatisfactory performance (R2 < 4%) in the other institutions. An improvement in R2 was observed after adjusting the coefficients for each hospital.
Conclusion
For the Nursing Activities Score prediction of survivors for ICU discharge, trauma centres must validate the original model with coefficient adjustments for their population, or preferably derive their own models.
Implications for nursing management
Although models are useful in predicting discharge of these ICU patients, for treatment continuity after critical care and for organising services, the study showed that they should be evaluated prior to use for nursing management.