Associations between two nursing workload scales and the cost of intensive care unit nursing staff: A retrospective study of one Belgian hospital

• Published in: Journal of nursing management Vol. 30; no. 3; pp. 724 - 732
• Main Authors: Bruyneel, Arnaud, Maes, Julie, Di Pierdomenico, Lionel, Tack, Jérôme, Bogaert, Martin, Leclercq, Pol, Pirson, Magali
• Format: Journal Article
• Language: English
• Published: England Hindawi Limited 01-04-2022
• Subjects: Belgium; care organisation; cost; Datasets; Funding; Health care expenditures; hospital funding; Hospitals; Humans; Intensive care; Intensive Care Units; Nurses; Nursing; nursing activities score; Nursing administration; Nursing Staff, Hospital; Quality of care; Retrospective Studies; Staffing; Workload; Workloads; Belgium; hospital funding; nursing activities score; workload; cost; care organisation
• ISSN: 0966-0429; 1365-2834
• DOI: 10.1111/jonm.13544

Aims
The aim of this study was to assess associations between a general nursing funding scale and an intensive care unit specific nursing workload scale and the cost of nursing staff.
Background
Nurse staffing represents the most important cost in the intensive care unit, so it is essential to evaluate it accurately. In addition, the assessment of nursing workload is important for the daily management of the intensive care unit and to ensure quality of care.
Methods
This was a retrospective and quantitative study carried out in the intensive care unit of a Belgian hospital. The extraction of data from the Nursing Activities Score and the Minimum Hospital Summary Nursing Dataset were carried out during 2 periods of 15 days, from 1 June 2018 to 15 June 2018 and from 1 September 2018 to 15 September 2018.
Results
A total of 234 patients were included in the study. A total of 773 Nursing Activities Score and Minimum Hospital Summary Nursing Dataset recordings were analyzed in the study per intensive care unit day. A strong correlation was observed between Nursing Activities Score and Minimum Hospital Summary Nursing Dataset for the entire intensive care unit stay with a rho (95% CI) of .88 (0.83–.93); however, the correlation was moderate per intensive care unit day with a rho of .51 (0.45–0.57). A strong association was observed between the Minimum Hospital Summary Nursing Dataset and the Nursing Activities Score with the costs of intensive care unit nurses with a rho (95% CI) of .78 (0.72–0.86) and .74 (0.65–0.84), respectively.
Conclusions
A general nursing funding scale in Belgium was strongly correlated with the nursing workload for the whole intensive care unit stay, but this correlation was moderate per intensive care unit day. In contrast, both scales showed a good correlation with intensive care unit nursing costs.
Implications for nursing management
In Belgium, a general funding scale for nurses does not allow for an assessment of the nursing workload in the intensive care unit. The Nursing Activities Score is strongly correlated with the cost of nursing staff in the intensive care unit. The authors recommend that the Belgian authorities carry out this type of study in several intensive care units in the country and eventually replace the general funding scale for nurses with the Nursing Activities Score.