• Leilane Andrade Gonçalves, Katia Grillo Padilha, and Regina M Cardoso Sousa.
• School of Nursing, University of São Paulo, Av Dr Eneas de Carvalho Aguiar 419, CEP 05403-000, São Paulo, SP, Brazil.
• Intensive Crit Care Nurs. 2007 Dec 1;23(6):355-61.

AbstractFor over 30 years in an attempt to demonstrate the cost-benefit ratio of the intensive care unit (ICU) a variety of tools have been developed to measure not only the severity of illness of the patient but also to capture the true cost of nursing workload. In this context, the nursing activities score (NAS) was developed as a result of modifications to the therapeutic interventions scoring system-28 (TISS-28). The NAS is a tool to measure nursing workload ICU and it has been shown to be twice as effective in measuring how nurses spend their time caring for critically ill patients than the TISS-28. This paper discuss the introduction of the NAS into everyday use in an intensive care unit in Brazil and highlights the challenges of standardisation of operational definitions, training requirements and accurate completion of the documentation when using such a tool. The rationale and steps undertaken to achieve this are outlined and the benefits of such a process are highlighted.

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