• Arnaud Bruyneel, Jérôme Tack, Marie Droguet, Julie Maes, Xavier Wittebole, Miranda D Reis DR University Medical Center of Groningen, the Netherlands., and Pierdomenico Lionel Di LD Research Center of Health Economics, Health Facility Administration and Nursing Science - Université Libre de Bruxelles, Belgium..
• SIZ Nursing, A Society of Intensive Care Nurses, Belgium; Haute Ecole Provinciale Condorcet, Mons, Belgium; Intensive Care Unit, CHU Tivoli, Belgium. Electronic address: arnaudbruyneel8@gmail.com.
• J Crit Care. 2019 Dec 1; 54: 205-211.

PurposeThe evaluation of nursing workload is a common practice in intensive care units (ICUs). It allows the calculation of an optimal nurse/patient ratio (N/P) which is a major challenge to ensuring the quality of care while controlling the costs of health care. The objectives of this study were, therefore, to evaluate the N/P ratio and to study nursing activities in intensive care in French-speaking Belgium.MethodsThe Nursing Activities Score (NAS) was prospectively recorded by shift for two periods of one month each in 16 French-speaking Belgian hospitals for a total of 316 ICU beds in 24 ICUs.ResultsWe included 3377 patients in the study, of which 64% were medical (versus surgical). The results for 24-hour NAS (68.6%) were significantly different from the NAS per shift (Morning: 61.3%, Afternoon: 58.4%, Night: 55.0%). Outliers were significantly more prevalent among men and patients who died and outliers had longer stays in the ICU. Finally, mobilization-positioning and clinical-administrative tasks took, on average, more time for nurses in the ICU.ConclusionsThere is a significant difference in N/P ratio between the Belgian regulation (1/3) and the one calculated by the NAS (1/1.5). A systematic objective assessment of shift workload should be done to avoid N/P ratio differences in intensive care.Copyright © 2019 Elsevier Inc. All rights reserved.

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