Nursing Activities Score (NAS): 5 years of experience in the intensive care units of an Italian University hospital

Objective: To retrospectively analyse the application of the Nursing Activities Score (NAS) in an intensive care department from January 2006 to December 2011.

Method: The sample consists of 5856 patients in three intensive care units (GICU: General Intensive Care Unit, NeuroICU: Neurosurgical Intensive Care Unit, CICU: Cardiothoracic Intensive Care Unit) of an Italian University hospital. The NAS was calculated for each patient every 24 hours. In patients admitted to general ICU, the following scores: SAPS 2 and SAPS 3 (Simplified Acute Physiology Score), RASS (Richmond Agitation Sedation Scale) and Braden were also recorded along with the NAS.

Results: The mean NAS for all patients was 65.97% (Standard Deviation ± 2.53), GICU 72.55% (± 16.28), NeuroICU 59.33% (± 16.54), CICU 63.51% (SD ± 14.69). The average length of hospital stay (LOS) was 4.82 (SD ± 8.68). The NAS was high in patients with increasing LOS (p<0.003) whilst there were no significant differences for age groups except for children 0-10 years (p<0.002). The correlation of NAS and SAPS 2 was r=0.24 (p=0.001), NAS and SAPS 3 r=-0.26 (p=0.77), NAS and RASS r=-0.23 (p=0.001), NAS and Braden r=0.22 (p=0.001).

Conclusions: This study described the daily use of the NAS for the determination of nursing workload and defines the staff required.