title: Nursing Activities Score: an updated guideline for its application in the Intensive Care Unit.
abstract: Objective To describe nursing workload in Intensive Care Units (ICU) in different countries according to the scores obtained with Nursing Activities Score (NAS) and to verify the agreement among countries on the NAS guideline interpretation. Method This cross-sectional study considered 1-day measure of NAS (November 2012) obtained from 758 patients in 19 ICUs of seven countries (Norway, the Netherlands, Spain, Poland, Egypt, Greece and Brazil). The Delphi technique was used in expertise meetings and consensus. Results The NAS score was 72.8% in average, ranging from 44.5% (Spain) to 101.8% (Norway). The mean NAS score from Poland, Greece and Egypt was 83.0%, 64.6% and 57.1%, respectively. The NAS score was similar in Brazil (54.0%) and in the Netherlands (51.0%). There were doubts in the understanding of five out 23 items of the NAS (21.7%) which were discussed until researchers' consensus. Conclusion NAS score were different in the seven countries. Future studies must verify if the fine standardization of the guideline can have a impact on differences in the NAS results.
authors.affiliation: Departamento de Enfermagem Médico-Cirúrgica, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Katia Grillo
authors.initials: KG
authors.lastname: Padilha
authors.affiliation: Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
authors.forename: Siv
authors.initials: S
authors.lastname: Stafseth
authors.affiliation: Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
authors.forename: Diana
authors.initials: D
authors.lastname: Solms
authors.affiliation: Isala klinieken Research Department Anesthesiologie & Intensive Care, Zwolle, Netherlands.
authors.forename: Marga
authors.initials: M
authors.lastname: Hoogendoom
authors.affiliation: Hospital Universitario Fundación Alcorcón, Madrid, España.
authors.forename: Francisco Javier Carmona
authors.initials: FJ
authors.lastname: Monge
authors.affiliation: Faculty of Nursing, Sohag University, Sohag, Egypt.
authors.forename: Om Hashem
authors.initials: OH
authors.lastname: Gomaa
authors.affiliation: Faculty of Nursing, University of Athens, Athens, Greece.
authors.forename: Konstantinus
authors.initials: K
authors.lastname: Giakoumidakis
authors.affiliation: Faculty of Nursing, University of Athens, Athens, Greece.
authors.forename: Margarita
authors.initials: M
authors.lastname: Giannakopoulou
authors.affiliation: Faculté des Sciences Infirmières, Université Laval, Quebec, Canada.
authors.forename: Maria Cecília
authors.initials: MC
authors.lastname: Gallani
authors.affiliation: Faculty of Health Sciences, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Edyta
authors.initials: E
authors.lastname: Cudak
authors.affiliation: Departamento de Enfermagem Médico-Cirúrgica, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Lilia de Souza
authors.initials: Lde S
authors.lastname: Nogueira
authors.affiliation: Departamento de Enfermagem Médico-Cirúrgica, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Cristiane
authors.initials: C
authors.lastname: Santoro
authors.affiliation: Departamento de Enfermagem Médico-Cirúrgica, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Regina Cardoso de
authors.initials: RC
authors.lastname: Sousa
authors.affiliation: Instituto de Geografia, Universidade Federal de Uberlândia, MG, Brazil.
authors.forename: Ricardo Luis
authors.initials: RL
authors.lastname: Barbosa
authors.affiliation: Former Researcher, University of Groningen, Groningen, Netherlands.
authors.forename: Dinis Dos Reis
authors.initials: Ddos R
authors.lastname: Miranda