. Measuring the nursing workload in a medical-surgical high dependency unit through nursing activities score (NAS). a prospective observational study.
Introduction: Measuring the nursing staff workload allows adequate delivery of resources within the intensive care unit and high dependency unit to ensure an adequate nurse to patient ratio.
Aim: Exploring the nursing workload in the medical-surgical high dependency unit (HDU) at Careggi University Hospital (Florence, Italy).
Methods: Monocentric prospective observational study. We enrolled patients admitted in HDU from 11 February to 13 March 2021. Nursing Activity Score (NAS) was measured every 24 hours.
Results: Patients included in the study were 75. Three groups based on their admission diagnosis were identified (medical, surgical, trauma). The median NAS score was 59.7 (IQR: 53.7-68.2; range 34.7-119.7). Statistically significant differences were found between the median NAS values for the three admission diagnoses: 67.4 (IQR: 54.4-73.4) for medical patients, 60.2 (IQR: 54.4-63.3) for trauma patients and 59.1 (IQR: 55.1-64.7) for surgical patients. These results showed that the items of NAS that mostly affect workload are "monitoring", "mobilization", "patient hygiene", and "admission and discharge procedures".
Conclusions: This study confirms that the NAS scoree can be used in HDUs as well as in intensive care units. The ideal nurse-to-patient ratio was equal to 0.6.