title: [The implementation of NEMS and NAS systems to assess the nursing staffing levels in a polyvalent intensive care unit].
abstract: NEMS and NAS scoring systems allow to calculate the number of nurses needed in an intensive care unit. Aim of the study is the assessment of nursing workload in a polyvalent intensive care unit, the evaluation of easiness of routine use of the systems and the assessment of the number of nurses needed.
  
  
  METHODS
  The NEMS and NAS scores of 752 patients admitted respectively from may 2004 and July 2006 and of 250 patients admitted from August 2006 to July 2007 were analysed and adjusted to the number of inpatients.
  
  
  RESULTS
  Mean NEMS score were 32.05 (+/- 2.11) and mean NAS scores 76.17 (+/- 14.66) and minutes of care needed per day 1009 according to NEMS and 1096 according to NAS. Medical patients have an higher workload compared to surgical (NAS Score 84.2 +/- 16.4 vs 79.0 +/- 12.4, p = 0.0047). The workload is influenced by the main illness (extracorporeal circulation: 102.26 +/- 5.70, shock. 88.00 +/- 1 7.48, cardio-circulatory arrest out of the ward: 81.95 +/- 15.46, ARDS 86.62 +/- 14.10) and by the day of admission, being higher at admission.
  
  
  CONCLUSIONS
  The routine assessment of patients' workload allows to measure the gap between nurses needed and available, to monitor patients with higher workload and to quantify the need of nursing care according to patients case-mix.
authors.affiliation: Dipartimento di medicina perioperatoria e terapie intensive -Teropia intensiva generale AO S. Gerardo, Monza, Università Milano-Bicocca.
authors.forename: Alberto
authors.initials: A
authors.lastname: Lucchini
authors.forename: Valeria
authors.initials: V
authors.lastname: Chinello
authors.forename: Veronica
authors.initials: V
authors.lastname: Lollo
authors.forename: Cristian
authors.initials: C
authors.lastname: De Filippis
authors.forename: Michela
authors.initials: M
authors.lastname: Schena
authors.forename: Stefano
authors.initials: S
authors.lastname: Elli
authors.forename: Maurizio
authors.initials: M
authors.lastname: Sasso
authors.forename: Giulia
authors.initials: G
authors.lastname: Pelucchi
authors.forename: Laura
authors.initials: L
authors.lastname: Poloniato
authors.forename: Maria
authors.initials: M
authors.lastname: Martino
authors.forename: Angelo
authors.initials: A
authors.lastname: Costanzo
authors.forename: Simona
authors.initials: S
authors.lastname: Vimercati