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Research
Validation of the Nursing Activities Score (NAS) using time-and-motion measurements in Dutch Intensive Care Units
Charlotte Margadant
Universiteit van Amsterdam
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1597-2147
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
The Nursing Activities Score (NAS) is widely used for workload measurement of Intensive Care Unit (ICU) nurses. However, the performance of the NAS to measure actual nursing time has not been comprehensively and externally validated. The aim of this study is to validate the NAS using time-and-motion measurements in Dutch ICUs.
Methods
We measured nursing time for patients admitted to seven Dutch ICUs, between November 2016 and October 2017. The patient(s) that were under the care of a chosen nurse were followed by the observers during the entire shift and measurements were performed using an in-house developed web application. To validate the reliability of the NAS, we first converted NAS points per activity into minutes. Next, we compared the converted time per NAS item and the converted total nursing time per patient with the actual observed time. We used Wilcoxon signed-rank tests at nursing activity level and Pearon’s R and R 2 at patient level for these comparisons.
Results
A Pearson’s correlation of R=0.59 (R 2 =0.35) was found between the total converted NAS time and the total observed time per patient. The median converted NAS time per patient (202.6 minutes) was higher compared to the observed time per patient (114.3 minutes). At NAS item level, we found significant differences between the converted NAS time and the observed time for all separate NAS items.
Conclusions
The NAS overestimates the needed nursing time for patients in Dutch ICUs. Therefore, we advise revisions of the time weights assigned to each NAS item to get better insight in the true nursing workload to enable the use of this information for more adequate nursing capacity planning.
Keywords: Nursing Activities Score (NAS), time-and-motion techniques, validation, nursing workload, patient acuity.
Keywords
Nursing Activities Score (NAS), time-and-motion techniques, validation, nursing workload, patient acuity
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This is a preprint. It has not completed peer review.
Research
Validation of the Nursing Activities Score (NAS) using time-and-motion measurements in Dutch Intensive Care Units
Charlotte Margadant
Universiteit van Amsterdam
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1597-2147
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 08 Jan, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
The Nursing Activities Score (NAS) is widely used for workload measurement of Intensive Care Unit (ICU) nurses. However, the performance of the NAS to measure actual nursing time has not been comprehensively and externally validated. The aim of this study is to validate the NAS using time-and-motion measurements in Dutch ICUs.
Methods
We measured nursing time for patients admitted to seven Dutch ICUs, between November 2016 and October 2017. The patient(s) that were under the care of a chosen nurse were followed by the observers during the entire shift and measurements were performed using an in-house developed web application. To validate the reliability of the NAS, we first converted NAS points per activity into minutes. Next, we compared the converted time per NAS item and the converted total nursing time per patient with the actual observed time. We used Wilcoxon signed-rank tests at nursing activity level and Pearon’s R and R 2 at patient level for these comparisons.
Results
A Pearson’s correlation of R=0.59 (R 2 =0.35) was found between the total converted NAS time and the total observed time per patient. The median converted NAS time per patient (202.6 minutes) was higher compared to the observed time per patient (114.3 minutes). At NAS item level, we found significant differences between the converted NAS time and the observed time for all separate NAS items.
Conclusions
The NAS overestimates the needed nursing time for patients in Dutch ICUs. Therefore, we advise revisions of the time weights assigned to each NAS item to get better insight in the true nursing workload to enable the use of this information for more adequate nursing capacity planning.
Keywords: Nursing Activities Score (NAS), time-and-motion techniques, validation, nursing workload, patient acuity.
Figure 1