Impact of different sampling strategies on score results of the Nine Equivalents of Nursing Manpower Use Score (NEMS)

Weak Correlation Between Perceived and Measured Intensive Care Unit Nursing Workload: An Observational Study

BACKGROUND

Efficient management of nursing workload in the intensive care unit (ICU) is essential for patient safety, care quality, and nurse well-being. Current ICU-specific workload assessment scores lack comprehensive coverage of nursing activities and perceived workload.

PURPOSE

The purpose of this study was to assess the correlation between ICU nurses' perceived workload and the Nine Equivalents of Nursing Manpower Use Score (NEMS).

METHODS

In a 45-bed adult ICU at a tertiary academic hospital, nurses' perceived shift workload (measured with an 11-point Likert scale) was correlated with the NEMS, calculated manually and electronically.

RESULTS

The study included 1734 observations. The perceived workload was recorded for 77.6% of observations. A weak positive correlation was found between perceived and objectively measured workload.

CONCLUSION

Findings indicate a need to consider the multifaceted nature of nursing activities and individual workload perceptions in the ICU.

Correlation between the TISS-28 and NEMS indicators in an intensive care unit

Cross-sectional study aimed to analyse and compare the correlation between the Therapeutic Intervention Scoring System (TISS)-28 and Nine Equivalents of Nursing Manpower Use (NEMS) indicators with a sample of 725 patients, for which data was collected from the computerized system of a university hospital. The findings of the present study well demonstrated a strong correlation between the TISS-28 and NEMS, both at the time of patient admission and discharge (0.888 and 0.885; P < 0.001), although there is a dispersion of 21% in the data and established cut-off points to discriminate with greater power the death and no death scenarios. Further research is still necessary to confirm the possibility of replacing the TISS-28 scoring instrument with NEMS.

Validação Concorrente de Escores de Enfermagem (NEMS e TISS-28) em terapia intensiva pediátrica

OBJETIVO: Examinar a validade concorrente do escore Nine Equivalents of Nursing Manpower Use Score (NEMS) em comparação ao Therapeutic Intervention Scoring System-28 (TISS-28) em uma Unidade de Terapia Intensiva Pediátrica (UTIP). MÉTODOS: Estudo de coorte prospectivo observacional, realizado na UTIP de um hospital universitário brasileiro, no período de dois anos, com uma amostra de 816 pacientes. Foram realizadas 7.702 observações de cada um dos escores. RESULTADOS: A média da pontuação máxima do NEMS foi 26,6±9,2 e do TISS-28 21,3±8,2. Em todas as médias, o TISS-28 foi inferior ao NEMS (p<0,001). Houve uma boa correlação entre eles (r²=0,704 para todas as observações). A concordância entre o TISS-28 e o NEMS foi boa, apresentando apenas 6,2% de diferença entre os escores. CONCLUSÃO: Os resultados mostraram boa correlação e concordância entre o TISS-28 e o NEMS, permitindo validar o NEMS nessa população de pacientes pediátricos.

[Nine Equivalents of Nursing Manpower Use Score (NEMS): a study of its historical process]

This study aims to describe, through an integrative review of literature, the historical trajectory of therapeutic intervention scores with emphasis on Nine Equivalents of Nursing Manpower Use Score in Intensive Care Units. The descriptors "Intensive care units" and "scales" were looked up in publications issued between 2000 and 2009. The terms selected were: "Nine Equivalents of Nursing Manpower Use Score" or "NEMS", "Unidade de Terapia Intensiva", "Therapeutic Intervention Scoring System-76", "Therapeutic Intervention Scoring System-28 or "TISS-28". As to the publications, "Medical Literature Analysis and Retrieval System Online" (MEDLINE) and "Literatura Latino-Americana e do Caribe em Ciências da Saúde" (LILACS) were selected Among the 295 papers reviewed, 18 were chosen, of which 55,5% were in English. The studies deal with NEMS (33,3%), Therapeutic Intervention Scoring System-76 (11,1%), TISS-28 (33,3%), among others. Research emphasized that NEMS has been a useful, operational and succinct tool.