Increased nursing workload in patients with sepsis: A cohort study

Objective: To assess the nursing workload using the Nursing Activities Score (NAS) and compare results between patients with and without sepsis at an adult intensive care unit. Methods: Prospective cohort study of patients admitted to the adult intensive care unit from March 10 to December 31, 2008. Clinical data of septic patients were collected in addition to data needed to calculate scores. Data were collected each day until release from the intensive care unit or up to 90 days of hospitalization. The nursing workload assessed using the Therapeutic Intervention Score System-28 and Nursing Activities Score relative to patients with and without sepsis were compared. The significance level was established at 5%. Results: A total of 437 patients were assessed (318 with and 119 without sepsis). The average nursing workload as measured by the Nursing Activities Score was high for the general intensive care unit (Nursing Activities Score = 74.7%). Patients with sepsis were associated with greater nursing workloads during their first two weeks in the intensive care unit compared with patients without sepsis ( p < .05). Patients with septic shock were associated with greater nursing workloads (median Nursing Activities Score = 75.62%, p < .001) compared with patients without sepsis (median Nursing Activities Score = 72.57%), those with sepsis (median Nursing Activities Score = 70.20%), and those with severe sepsis (median Nursing Activities Score = 72.65%). Conclusions: Sepsis increased nursing workload during the first two weeks after admission to the intensive care unit and the NAS may be useful to capture these differences.