Caso de Sucesso


President: Arnaud Bruyneel, RN, CRRN, MSc
Intensive care nurse at the CHU Tivoli, La Louvière; Assistant Professor at the Haute École Provinciale de Hainaut – Condorcet, Mons; Member of the Council – European federation of Critical Care Nurses association

SIZ Nursing, asbl:

SIZ Nursing is the association of intensive care nurses in French-speaking Belgium that has existed since 1982. This science-based professional association, incorporated as an asbl (non-profit association) since October 2005, is a member of the European federation of Critical Care Nursing associations (EfCCNa).

The NAS project

The Nursing Activities Score (NAS) measures the workload of nurses in intensive care units (ICUs) to better map out their activities.

The objective of the NAS project in Belgium is to assess the nurse/patient ratio against the current situation in the French-speaking region.

Sixteen hospitals in total participated in the project using the NAS module of the Epimed Monitor ICU system over two periods of one month each (January and June). Mr Bruyneel, who 2 years earlier had learned about the MICA (Monitoring Intensive Care Activities) project in Belgium through Dr Brimioulle, contacted Epimed Solutions leading to the collaboration in the use of the system as a working tool within the NAS project: ‘‘The project came to fruition thanks to the support of Epimed Solutions Belgium, who allowed the 16 participating hospitals to freely use the NAS module. We could have done the same study using only Excel spreadsheets, but it would have been more difficult to coordinate it and retrieve the results.’’

The Epimed Monitor ICU system:

The fact that the Epimed Monitor ICU system is available online (web-based software) has made it very easy to retrieve data. These data were entered into one single archive. According to Mr Bruyneel, it would have taken more than 6 months to carry out the analyses if the hospitals did not use a standardised online system such as that of the Epimed Monitor ICU: ‘‘Moreover, during the study the head nurses were able to analyse their results in real-time in a clear and concise manner, as the system is able to automatically process various reports.’’


Several results were obtained thanks to the study. The key highlight, however, was the analysis of the mean NAS per patient.

We are pioneers in this type of analysis, as well as in implementing a project in a large number of hospitals, making this multi-centre study one of the most important ever done on the NAS score.’’ The study made it possible to analyse the time spent with patients, leading to the conclusion that patients staying longer in the ICU and deaths create a greater workload for nurses.

Other studies have found that the impact of nursing workload influences the quality of care provided, hospital-acquired infections and complications, and patient mortality. The NAS study highlights that a change in legislation is required to increase the nurse-patient ratio in ICUs; once it is proven that the quality of care needs to be improved, it is also necessary to adapt the working hours of these professionals.

Mr Bruyneel considers that the study would have been even more relevant if all the hospitals has also participated in the MICA Project, making it possible to establish relations between the NAS results, the pathologies of patients and their severity scores. For him and his collaborators, there is still much room for research using the NAS score, enabling hospitals to continue to use the Epimed Monitor ICU module system, thus contributing to the management and research. Mr Bruyneel thanks his colleagues for drafting the study, and also all the nurses who entered data into the NAS.