Marga Hoogendoorn

152 Appendix 2 Nursing Activity Score – weight list (Miranda, D.R. et al. 2003, Crit Care Med; Padilha et al. 2015, Rev Esc Enferm USP) BASIC ACTIVITIES NAS-points 1 Monitoring and titration 1a Hourly vital signs, regular registration and calculation of fluid balance 4.5 1b Present at bedside and continuous observation or active for 2 hours or more in any shift, for reasons of safety, severity or therapy, such as: non- invasive mechanical ventilation, weaning procedures, restlessness, mental disorientation, prone position, donation procedures, preparation and administration of fluids and/or medication, assisting specific procedures 12.1 1c Present at bedside and active for 4 hours or more in any shift for reasons of safety severity or therapy, such as those examples above (1b) 19.6 2 Laboratory Biochemical and microbiological investigations 4.3 3 Medication Vasoactive drugs excluded 5.6 4 Hygiene procedures 4a Performing hygiene procedures such as: dressing of wounds and intravascularcatheters, changing linen, washing patient, incontinence, vomiting, burns, leaking wounds, complex surgical dressing with irrigation, special procedures (e.g. barrier nursing, cross-infection related, room cleaning following infections, staff hygiene), etc 4.1 4b The performance of hygiene procedures took more than 2 hours in any shift 16.5 4c The performance of hygiene procedures took more than 4 hours in any shift 20.0 5 Care of drains All (except gastric tube) 1.8 6 Mobilization and positioning , including procedures such as: turning the patient; mobilization of the patient; moving from bed to chair; team lifting (e.g. immobile patient, traction, prone position) 6a Performing procedure(s) up to 3 times per 24 hours 5.5 6b Performing procedure(s) more frequently than 3 times per 24 hours, or with 2 nurses - any frequency 12.4 6c Performing procedure with 3 or more nurses - any frequency 17.0 7 Support and care of relatives and patient, including procedures such as telephone calls, interviews, counseling. Often, the support and care of either relatives or patient allow staff to continue with other nursing activities (e.g.: communication with patients during hygiene procedures, communication with relatives whilst present at bedside and observing patient)