Assessing the adequacy of workload measurement tools using a quality-based methodology.

Objective: determine which tool (NEMS and NAS) is most suitable for use in intensive care units using a quality-based methodology. Method: after identifying the opportunity for improvement "Inadequacy of the NEMS for determining nursing workload in the intensive care unit (ICU)", we assessed the NEMS and the NAS, as a proposed improvement to the NEMS, using quality improvement cycles methodology based on the following criteria: measurement of daily nursing workload on a daily and shift basis; the tool encompasses all nursing activities undertaken in the ICU; and workload assessed per patient and unit. Results: there was no significant difference in level of compliance for the NEMS (67%). The comparison NEMS-NAS showed that there was a statistically significant improvement for all criteria except criterion 1. The NEMS only assesses criterion 1 (64.22%); while the NAS assessed all four criteria, obtaining a compliance rate of 64.74% for criteria 1, 2, and 4, and 100% for criterion 3. Conclusion: the NAS is more suitable for measuring nursing workload in UCIs.