Workload analysis and calculation of nurse/patient ratio in intensive care in patients treated with hypothermia after out-of-hospital cardiac arrest
Section: Artículos Científicos
How to quote
Enferm Cardiol. 2019;26(76):43-53
Authors
Milagros Royo Puerto1, Ana Belén Araiz Marín2, Marta Palacios Laseca3, Nuria Gago Gallego1, Rut Latorre Navascuez1, Javier Bascuas Hernández4.
Position
1 Diplomada en Enfermería. Servicio de Medicina Intensiva. Hospital Clínico Universitario Lozano Blesa (HCUZ), Zaragoza.2 Graduada en Enfermería. Servicio de Medicina Intensiva, HCUZ.3 Graduada en Enfermería. Máster en Gerontología. Servicio de Medicina Intensiva, HCUZ.4 Doctor en Medicina. Profesor Asociado en Ciencias de la Salud de la Universidad San Jorge, Zaragoza.
Contact address
Servicio de Medicina Intensiva. Hospital Clínico Universitario Lozano Blesa. C/ San Juan Bosco, 15. 50009 Zaragoza
Contact email: mila_royo@hotmail.com
Abstract
Introduction. During the last few years, new measures and treatments have been implemented in patients with out-of-hospital cardiac arrest, among them: therapeutic hypothermia, for its neuroprotective effect. These changes are not accompanied by a new calculation of nursing workload. Objective. To evaluate the workload of the nursing staff in connection with patients with out-of-hospital cardiac arrest who have been treated with therapeutic hypothermia.
Material and methods. Retrospective cohort study analyzing prospectively collected data in a Coronary Unit. Included therein are all patients admitted for out-of-hospital cardiac arrest during 2015 and 2016, whether treated with therapeutic hypothermia or not, as well as a patient control group with acute coronary syndrome who had not suffered from cardiac arrest. Nursing workloads are calculated with the aid of those scales most frequently used in intensive care: TISS28 and NEMS, which quantify workload in relation with patient‘s gravity, and NAS and VACTE®, which measure health effort regardless of pathologies. Finally, nurse/patient ratios are calculated for each group studied.
Results. Eighty eight patients were included, out of which 30 had suffered from out-of-hospital cardiac arrest, 13 of them having been treated with therapeutic hypothermia and 17 having not, and 58 assigned to the control group. The group of patients with cardiorespiratory arrest having been treated with therapeutic hypothermia showed a greater workload in all scales used. TISS28, NEMS and NAS scales showed a good correlation with respect to VACTE© (r > 0.80; R2 > 0.75).
Conclusions. Patients with recovered out-of-hospital cardiorespiratory arrest having been treated with therapeutic hypothermia present important nursing workloads, as they need a nurse/patient ratio of 1:1.
Keywords:
intensive care unit; workload; heart arrest; hypothermia; induced; resources management
Versión en Español
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