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BACKGROUND: Nursing Activities Score (NAS) is a promising tool for calculating the nursing workload in intensive care units (ICU). However, data on intensive care nursing activities in Portugal are practically non-existent. AIM: To assess the nursing workload in a Portuguese ICU using the NAS. STUDY DESIGN: Retrospective cohort study developed throughout the analysis of the electronic health record database from 56 adult patients admitted to a six-bed Portuguese ICU between 1 June-31 August 2020. The nursing workload was assessed by the Portuguese version of the NAS. The study was approved by the Hospital Council Board and Ethics Committee. The study report followed the STROBE guidelines. RESULTS: The average occupancy rate was 73.55% (±16.60%). The average nursing workload per participant was 67.52 (±10.91) points. There was a correlation between the occupancy rate and the nursing workload. In 35.78% of the days, the nursing workload was higher than the available human resources, overloading nurse staffing/team. CONCLUSIONS: The nursing workload reported follows the trend of the international studies and the results reinforce the importance of adjusting the nursing staffing to the complexity of nursing care in this ICU. This study highlighted periods of nursing workload that could compromise patient safety. RELEVANCE TO CLINICAL PRACTICE: This was one of the first studies carried out with the NAS after its cross-cultural adaptation and validation for the Portuguese population. The nursing workload at the patient level was higher in the first 24 h of ICU stays. Because of the 'administrative and management activities' related to the 'patient discharge procedures', the last 24 h of ICU stays also presented high levels of nursing workload. The implementation of a nurse-to-patient ratio of 1:1 may contribute to safer nurse staffing and to improve patient safety in this Tertiary (level 3) ICU.

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Enquadramento: É reconhecida a importância da partilha de informação na continuidade dos cuidados, sendo um desafio para os enfermeiros a decisão sobre qual a informação a partilhar. Objetivo: Compreender o teor da informação partilhada pelos enfermeiros durante a passagem do turno, no serviço de urgência. Metodologia: Estudo qualitativo, exploratório, com recurso ao focus group como método de recolha de dados, tendo participado 13 enfermeiros reconhecidos pelos seus pares como peritos em urgência. Resultados: Após a análise das transcrições emergiram 4 categorias (Informação relativa ao cliente; Evolução do estado de saúde; Tipo de comunicação e Fatores condicionantes da passagem de turno), que demonstram o teor da informação partilhada entre os enfermeiros no serviço de urgência. Conclusão: Os enfermeiros estão sensibilizados para a importância da informação partilhada durante a passagem de turno, tendo consciência que esta pode ser substancialmente melhorada. Para tal, durante a passagem de turno deve ser partilhada informação sobre identificação do cliente, situação atual, informações pertinentes, antecedentes de saúde, cuidados prestados e plano de cuidados.

Background: The importance of sharing information in the continuity of care is acknowledged, and it is a challenge for nurses to decide which information must be exchanged. Objective: To understand the content of the information exchanged by nurses during shift handover in the emergency room. Methodology: A qualitative, exploratory study using focus group as a method for data collection, involving 13 nurses acknowledged by their peers as emergency experts. Results: From the analysis of the transcripts 4 categories emerged (Patient information, Health status development, Type of communication and Constraints of the shift handover), which demonstrate the content of the information shared by nurses in the emergency room. Conclusion: Nurses are made aware of the importance of shared information during shift handover, acknowledging that this information can be substantially improved. In order to accomplish that, information about patient identification, current health status, relevant information, medical history, type of care provided, and care plan should be shared during the shift handover.

Marco contextual: Se reconoce la importancia de compartir la información en la continuidad de la atención, y los enfermeros se enfrentan al reto de decidir qué información compartir. Objetivo: Comprender el contenido de la información compartida por los enfermeros durante el cambio de turno en el servicio de urgencias. Metodología: Estudio cualitativo y exploratorio, para el cual se utilizó el grupo focal como método de recogida de datos, con la participación de 13 enfermeros reconocidos por sus pares como expertos en urgencias. Resultados: Tras el análisis de las transcripciones, surgieron 4 categorías (Información relacionada con el paciente; Evolución del estado de salud; Tipo de comunicación y Factores que afectan al cambio de turno), que demuestran el contenido de la información compartida entre los enfermeros del servicio de urgencias. Conclusión: Los enfermeros son conscientes de la importancia de la información compartida durante el turno, y saben que puede mejorarse sustancialmente. Con este fin, durante el cambio de turno, se debe compartir información sobre la identificación del paciente, la situación actual, la información relevante, los antecedentes médicos, la atención prestada y el plan de atención.

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