title: Nursing Activity Score for estimating nursing care need in intensive care units: findings from a face and content validity study.
abstract: OBJECTIVE
  To re-evaluate the face and content validity of the Nursing Activity Score currently adopted in evaluating activities that best describe workloads in intensive care units and their weight in describing average nursing time consumption.
  
  
  BACKGROUND
  The Nursing Activity Score calculates the amount of nursing time that each patient will require over the next 24 hours. It has been widely used around the world since its first validation in 2003. However, no re-evaluation of its validity with regard to the advancements achieved in intensive care units nursing care has been documented to date.
  
  
  METHODS
  A research project was undertaken from 2012 to 2015, aimed at critically evaluating and validating this tool in the current context of Italian intensive care units nursing care. The 23 items were translated forward and backward into the Italian language, then a panel of 10 experts in critical care evaluated the face validity. Content validity was evaluated through focus groups involving seven critical care expert registered nurses.
  
  
  RESULTS
  The Nursing Activity Score instrument has been considered as not fully adequate to measure current intensive care units nursing activities and their weightings have been considered not fully adequate to score average nursing time consumption. From the content validity process, lack of adequacy has emerged with respect to the concept of nursing care underpinning the tool, the interventions included, its capability to predict the nursing resources needed, advancements achieved in intensive care units nurses' roles and competences, and the contextual factors that may influence consumption of nursing time.
  
  
  CONCLUSIONS
  Development of the Nursing Activity Score tool both conceptually and in its structure, in view of the innovations that have occurred in the context of intensive care units, is necessary to continue to have a common tool to help clinicians and managers to capture accurately and compare nursing care required by patients in critical care settings.
  
  
  CONCLUSIONS
  There is a need to revise the Nursing Activity Score tool, enabling its use in estimating nursing workloads in current Italian intensive care units practice. A taskforce of clinical nurses and nursing managers, capable of protecting the valuable original Nursing Activity Score project and to advance its further development is recommended.
authors.affiliation: University of Udine, Italy.
authors.forename: Alvisa
authors.initials: A
authors.lastname: Palese
authors.affiliation: Department of Anesthesia and Intensive Care, Academic Hospital of Udine, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Comisso
authors.affiliation: Department of Anesthesia and Intensive Care, Academic Hospital of Udine, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Burra
authors.affiliation: Week Surgery Department, Academic Hospital of Udine, Italy.
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: DiTaranto
authors.affiliation: Department of Anesthesia and Intensive Care, Academic Hospital of Udine, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Peressoni
authors.affiliation: Department of Anesthesia and Intensive Care, Academic Hospital of Udine, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Mattiussi
authors.affiliation: Intensive Care and Emergency Department, San Gerardo, Hospital, Monza, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Lucchini
mesh_terms: D064648:Critical Care Nursing; D006801:Humans; D007362:Intensive Care Units; D007558:Italy; D007802:Language; D015203:Reproducibility of Results; D014175:Translating; D000078329:Workforce; D016526:Workload / Q000523:psychology / Q000592:standards*
keywords: Italian; content validation; critical care nursing; face validation; intensive care units; nursing activity score; nursing workload