Drawing the Line Between Medium Care and Intensive Care. A Prospective Observational Study Based on the Nursing Activities Score

The aim of the study is to develop a screening instrument, based on the nursing activities score, by which we can distinguish medium care patients from the intensive care patients in terms of nurse staffing.

The main study question is: What is the most discriminative NAS cut off for medium care patient?

Each nursing shift the NAS and TISS 28 scores will be calculated for each patient who is admitted to the 8 participating units.

Nurses will be asked to answer 3 questions (see detailed description here under)at the end of their working shift concerning each patient appointed to them.

Each morning medical staff and head nurses will be asked 2 questions (see detailed description here under) for concerning patient admitted to there ward.

In order to determine the NAS cut off for medium care patient, all morning questionnaire scores will be compared to the NAS an TISS28 scores of that same morning.

Secondary study questions are:

• Can NAS score based on one nursing shift predict the severity of care in the subsequent nursing shift?
• Is there a difference in appreciation of severity of care between nurses, head nurses and medical staff?
• Which variables influence the perception of severity of care?
• How does NAS relate to TISS28, APACHE and NEMS?

Study Overview

• Status: Completed
• Conditions: Critical Illness

Detailed Description

Nursing questionnaire:

1. How many beds were appointed to you?

   1. 1
   2. 2
   3. 3
   4. 4
   5. 5
   6. 6

2. For how many of such patients you could care for maximally?

   1. 1
   2. 2
   3. 3
   4. 4
   5. >4

3. This patients' burden of care corresponds to:

   1. An intensive care patient who requires more than standard intensive care
   2. An intensive care patient who requires standard intensive care
   3. A medium care patient

medical staff and head nurse questionaire:

1. For how many of such patients you could care for maximally?

   1. 1
   2. 2
   3. 3
   4. 4
   5. >4

2. This patients' burden of care corresponds to?

   1. An intensive care patient who requires more than standard intensive care
   2. An intensive care patient who requires standard intensive care
   3. A medium care patient

• Study Type: Observational
• Enrollment (Anticipated): 1000

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

acute patients

Description

Inclusion Criteria:

• admission to one of the 9 critical area's

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Acute patients; Patients admitted to the surgical and general ICU (including burn unit), to the coronary care unit, to the emergency department high care zone, to the medical ICU, to the medical medium care unit

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
most discriminative NAS cut off for identifying medium care patient versus intensive care patient	1 year

Collaborators and Investigators

• Sponsor: KU Leuven
• Investigators: Study Director: Greet Van den Berghe, MD PhD, Catholic University Leuven; Principal Investigator: Karen Decock, RS, Universitaire Ziekenhuizen KU Leuven

Study record dates

Study Major Dates

• Study Start: February 1, 2013
• Primary Completion (Actual): September 1, 2013
• Study Completion (Actual): September 1, 2013

Study Registration Dates

• First Submitted: July 2, 2012
• First Submitted That Met QC Criteria: July 3, 2012
• First Posted (Estimate): July 4, 2012

Study Record Updates

• Last Update Posted (Estimate): January 29, 2014
• Last Update Submitted That Met QC Criteria: January 28, 2014
• Last Verified: January 1, 2014

More Information

Terms related to this study

• Keywords: intensive care; severity of illness; scoring; medium care; staffing
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Critical Illness
• Other Study ID Numbers: NAS-ICU-2012