- Poster presentation
- Open Access
Nursing workload and prognosis in the critically ill obstetric patient
Critical Care volume 9, Article number: P215 (2005)
A critically ill obstetric patient usually recovers rapidly after delivery, resulting in a short length of stay (LOS), with a reduced number of specific interventions in the ICU and a good overall prognosis. Some authors therefore stated a possible management of these patients on the delivery/labor floor or in high dependency units.
To measure nursing workload with the NEMS score , evaluate whether management in the ICU was required (NEMS > 20) and correlation with mortality.
A retrospective chart review study.
An independent multidisciplinary ICU in a tertiary university hospital.
January 1996–June 2004.
All obstetric patients (n = 590) admitted to the ICU.
Measurements and results
Forty-nine patients were excluded due to insufficient data. Mean NEMS was 27.1 ± 6.75 with values ranging from 18 to 50. Mean NEMS for survivors was 25.8 ± 5.19, mean NEMS for nonsurvivors was 37.75 ± 8.78 (P < 0.001). A total 21.6% (n = 117) of our patients got a NEMS score < 20 (mean 18), among them 18 patients (15.4%) either increased their NEMS the next day and then died, or lasted with the same NEMS for a few days.
NEMS_H24 discriminated well with an AUROC of 0.855 ± 0.072, but calibrated badly (Pr < 0.001). Also NEMS_H48 (after excluding patients with LOS < 2 days) discriminated well (AUROC = 0.977), and calibrated better than NEMS_H24 but still insufficiently (Pr = 0.02).
According to the NEMS score 81.7% of our patients deserved to be hospitalized in the ICU. NEMS_H24 and NEMS_H48 correlated with mortality. Fifteen percent of patients with initial NEMS < 20 needed intensive monitoring for more than 1 day, and five patients died. We suggest a large admission policy to a multidisciplinary ICU be encouraged for obstetric patients, because monitoring is better and treatment of possible late complications occurs earlier, a sole guarantee to reduce mortality.
R Moreno, DR Miranda: Nursing staff in intensive care in Europe. The mismatch between planning and practice. Chest 1998, 113: 752-758.
About this article
Cite this article
Haddad, Z., Kaddour, C. Nursing workload and prognosis in the critically ill obstetric patient. Crit Care 9, P215 (2005). https://doi.org/10.1186/cc3278
- Chart Review
- Late Complication
- Insufficient Data
- Retrospective Chart Review
- High Dependency