Confiabilidad inter-observador del Nursing Activities Score entre profesionales de la salud en una Unidad de Cuidado Intensivo

Objetivo : Analizar la confiabilidad inter-observador del NAS entre administradores y enfermeras clínicas en la UCI. Método : Estudio metodológico desarrollado en una UCI general en Noruega. En una muestra seleccionada el NAS fue aplicado en 101 pacientes críticos por tres clases de evaluadores: Enfermeras asistenciales, médicos intensivistas y enfermeras gestoras. La confiabilidad inter-observador fue analizada mediante el test de Kappa. Resultados : Los promedios del NAS fueron 88,4(DE=16,2) y 88,7(DE=24,5) respectivamente para las enfermeras asistenciales y gestoras. Los médicos obtuvieron un promedio NAS inferior 83,7;DE=21,1). Las 18 intervenciones médicas tuvierón mayor concordancia entre las enfermeras asistenciales y los médicos (85,6), en comparación con las enfermeras asistenciales y gestoras (78,7). En las cinco actividades de enfermería, los coeficientes Kappa fueron bajos entodas las actividades y entre todos los grupos. Conclusión : El estudio mostró confiabilidad inter-observador satisfactorias para el NAS entre las enfermeras asistenciales y gestoras.Objetivo Analisar a confiabilidade interobservadores do NAS entre enfermeiros intensivistas e administradores em UTI. Método Estudo metodológico desenvolvido em UTI geral, de adultos, na Noruega. Em uma amostra selecionada, o NAS foi aplicado em 101 pacientes por três avaliadores: enfermeira assistencial, médico intensivista e enfermeira gestora. A confiabilidade interobservadores foi analisada por meio do teste Kappa. Resultados As médias NAS foram 88,4(SD=16,2) e 88,7(SD=24,5) respectivamente para enfermeiros assistenciais e gestores. Os médicos obtiveram média NAS inferior (83,7; SD=21,1). As 18 intervenções médicas tiveram maior concordância entre enfermeiros assistenciais e médicos (85,6), comparativamente aos enfermeiros assistenciais e gestores (78,7). Nas cinco atividades de enfermagem, os coeficientes Kappa foram baixos em todas as atividades e entre todos os grupos. Conclusão O estudo mostrou confiabilidade interobservadores satisfatória para o NAS entre enfermeiros assistenciais e gestores.Objective To analyze the interrater reliability of NAS among critical care nurses and managers in an ICU. Method This was a methodological study performed in an adult, general ICU in Norway. In a random selection of patients, the NAS was scored on 101 patients by three raters: a critical care nurse, an ICU physician and a nurse manager. Interrater reliability was analyzed by agreement between groups and kappa statistics. Results The mean NAS were 88.4 (SD=16.2) and 88.7 (SD=24.5) respectively for the critical care nurses and nurse managers. A lower mean of 83.7 (SD=21.1) was found for physicians. The 18 medical interventions showed higher agreement between critical care nurses and physicians (85.6%), than between critical care nurses and nurse managers (78.7). In the five nursing activities the Kappa-coefficients were low for all activities in all compared groups. Conclusion The study indicated a satisfactory agreement of nursing workload between critical care nurses and managers

«Lite visste vi hvordan vårsemesteret 2020 ville bli» – en tverrsnittstudie om pandemiens innvirkning på intensivsykepleiestudentenes opplevelser i vårsemesteret 2020

Bakgrunn: Midt i vårsemesteret 2020 ble SARS-CoV-2 erklært som pandemi. Studiehverdagen til landets intensivsykepleiestudenter ble brått snudd på hodet. All undervisning ble digital, og det var stor usikkerhet rundt gjennomføringen av praksisstudier. Mangelen på intensivsykepleiere ble tydeliggjort, og utdanning av flere intensivsykepleiere mer kritisk. Hensikt: Hensikten med studien var å kartlegge hvilke erfaringer intensivsykepleiestudentene i masterprogram hadde i vårsemesteret 2020 under covid-19-pandemien i Norge. Metode: Studien er en beskrivende tverrsnittstudie med bruk av spørreskjema. Spørreskjemaet ble testet gjennom en pilotstudie, og sendt ut til alle landets intensivsykepleiestudenter som var i en videreutdanning som tilbød mastergrad. Resultat: Svarprosenten i studien var 29,2 prosent (n = 56). I teoretiske emner oppnådde 75 prosent av studentene sine læringsmål, og i kliniske emner oppnådde 76,8 prosent sine læringsmål. Digital undervisning medførte at 60,7 prosent (n = 34) opplevde svekket studiemotivasjon. Halvparten av studentene opplevde redusert mulighet for veiledning i klinisk praksis, og 64,3 prosent erfarte at de ble brukt som arbeidskraft på praksisstedet. Kun 34 prosent opplevde å få beholde sin studentrolle, og 23,3 prosent tviler på om de vil fortsette i yrket. Konklusjon: Våre resultater viser at første fase av pandemien medførte endringer i undervisning, praksisstudier og veiledning, som medførte lavere læringsutbytte og motivasjon. Flertallet av respondentene oppnådde likevel sine læringsmål i både teoretiske og kliniske emner. Funnene viser at opplevelse av å bli brukt som arbeidskraft i praksis, og tap av studentrolle, er faktorer som reduserer motivasjon til å både gjennomføre studiet og å fortsette i yrket. Studien viser at det å være student i en pandemi er utfordrende fordi pandemien medførte endringer i studenthverdagen.publishedVersio

Nursing Activities Score: an updated guideline for its application in the Intensive Care Unit

Objetivo Describir la carga de trabajo de enfermería en Unidades de Cuidados Intensivos (UCI) de diferentes países según el Nursing Activities Score (NAS) y establecer una guía estandarizada para su utilización en UCI. Método estudio observacional en 19 UCIs de siete países (Noruega, Países Bajos, España, Polonia, Egipto, Grecia y Brasil) incluyendo 758 pacientes adultos en Noviembre de 2012. Resultados La puntuación media total en la escala NAS fue de 72.81% com valores entre 44.46% (España) y 101.8% (Noruega). Las medias NAS en Polonia, Grecia y Egipto fue de 83.0%, 64.59% y 57.11% respectivamente. El NAS medio fue similar en Brasil (53.98%) y los Países Bajos (50.96%). De los 23 ítems de la escala hubo problemas en la interpretación de 5 de ellos (21.74%). Este problema se resolvió mediante el consenso entre los investigadores. Conclusión El presente estudio demuestra variación en la carga de trabajo en UCI de diferentes países. La guía estandarizada de puntuación del NAS puede servir como una herramienta para resolver dudas en futuras aplicaciones.Objetivo Descrever a carga de trabalho de enfermagem em Unidades de Terapia Intensiva (UTI) de diferentes países, segundo o Nursing Activities Score (NAS), e padronizar o manual do NAS para uso nessas Unidades. Método Estudo transversal realizado em 19 UTI de sete países (Noruega, Holanda, Espanha, Polônia, Egito, Grécia e Brasil) com um total de 758 pacientes adultos, em novembro de 2012. Resultados A média do NAS total da amostra foi 72.81%, com variação entre 44.46% (Espanha) e101.81% (Noruega). Nas UTI da Polônia, Grécia e Egito, as médias foram de 83.00%, 64.59% e 57.11%, respectivamente. As médias NAS no Brasil (53.98%) e na Holanda (50,96%) foram similares. Dos 23 itens da escala, houve dúvidas no entendimento de 5(21.74%), que foram solucionados por consenso entre os pesquisadores. Conclusão O estudo mostrou diferentes cargas de trabalho de enfermagem nas UTI estudadas. Um manual padronizado do NAS para uso nessas unidades contribuirá para sanar dúvidas em futuras aplicações.Objective To describe nursing workload in Intensive Care Units (ICU) in different countries according to the scores obtained with Nursing Activities Score (NAS) and to verify the agreement among countries on the NAS guideline interpretation. Method This cross-sectional study considered 1-day measure of NAS (November 2012) obtained from 758 patients in 19 ICUs of seven countries (Norway, the Netherlands, Spain, Poland, Egypt, Greece and Brazil). The Delphi technique was used in expertise meetings and consensus. Results The NAS score was 72.8% in average, ranging from 44.5% (Spain) to 101.8% (Norway). The mean NAS score from Poland, Greece and Egypt was 83.0%, 64.6% and 57.1%, respectively. The NAS score was similar in Brazil (54.0%) and in the Netherlands (51.0%). There were doubts in the understanding of five out 23 items of the NAS (21.7%) which were discussed until researchers’ consensus. Conclusion NAS score were different in the seven countries. Future studies must verify if the fine standardization of the guideline can have a impact on differences in the NAS results

Assessment of Nursing intensity with Nursing Activities Score in Norwegian Intensive Care Units

The aim was to test: the reliability and validity of the Nursing Activities Score (NAS) in relation to nursing intensity (NI) and nurse staffing costs and to examine: how the use of the NAS by critical care nurses can provide a tool for hospital administrators in Norwegian Intensive Care Units (ICUs). The instrument NAS assess nursing activities, including patients’ critical care needs and quantifies workload. The study method was a quantitative observational design and used in three studies and data were collected from internal quality registers, patients’ records and the Norwegian Intensive Care Registry. The study samples were 235/219/ 6,390 patients. The NAS tool was found to be reliable and valid in relation to the assessment of NI and emerging from the confirmatory factor analysis, a reduced three-factor model based on ICU patients’ NAS scores, with the latent factors “relationship”, “prevention” and “treatment”, confirmed the conceptual model of critical care nursing. The NAS is an applicable tool in identification of patients’ care needs in critical care and can be used to describe nurse staffing costs in Norwegian ICUs. Hospital administrators can use the NAS to make budgetary decisions for ICU contexts

Nursing of Criticall Ill Patients in Prone Position in an Intensive Care Unit, 2001

The purpose of the survey is to describe and evaluate the condition in prone positions, with perspective taken from Dorothe Orems eight universal self care requisites

Nursing Activities Score: an updated guideline for its application in the Intensive Care Unit

Objective To describe nursing workload in Intensive Care Units (ICU) in different countries according to the scores obtained with Nursing Activities Score (NAS) and to verify the agreement among countries on the NAS guideline interpretation. Method This cross-sectional study considered 1-day measure of NAS (November 2012) obtained from 758 patients in 19 ICUs of seven countries (Norway, the Netherlands, Spain, Poland, Egypt, Greece and Brazil). The Delphi technique was used in expertise meetings and consensus. Results The NAS score was 72.8% in average, ranging from 44.5% (Spain) to 101.8% (Norway). The mean NAS score from Poland, Greece and Egypt was 83.0%, 64.6% and 57.1%, respectively. The NAS score was similar in Brazil (54.0%) and in the Netherlands (51.0%). There were doubts in the understanding of five out 23 items of the NAS (21.7%) which were discussed until researchers’ consensus. Conclusion NAS score were different in the seven countries. Future studies must verify if the fine standardization of the guideline can have a impact on differences in the NAS results

Testing the reliability and validity of the Nursing Activities Score in critical care nursing

Background and Purpose: The purpose of this study was to test the reliability and validity of the conceptual model of critical care nursing using the Nursing Activities Score (NAS) for intensive care unit (ICU) patients. Methods: An observational study conducted in 2011 using the NAS scores of 219 patients in Norway. The inter-rater reliability (IRR) was tested by parallel classifications. The validity was explored by an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) as the measurement models in the structural equation model. Results: Within the paired ratings the Spearman's correlation coefficient was 0.39. The EFA results explained 77% of the variance with six factors. The reduced CFA model resulted in a three-factor model: relationship, prevention and treatment. Conclusion: The findings supported the IRR and construct validity of the conceptual model of the NAS