Integrating the measurement of nursing activities with patients into the daily routine of Quebec City's intensive care units: demonstration of added value for management and patient outcomes


Identifying the nature and intensity of nursing activities required to meet the needs of each patient is essential for determining the optimal nurse-to-patient ratio and therefore for short- and medium-term nursing staff planning. This information also makes it possible to estimate the patient-cost for direct costs related to direct care, which vary greatly from one patient to another, especially in the context of intensive care units (ICU) as well as to contribute to the budget planning of these units, which are among the most expensive in the hospital system. In Quebec, no instrument is yet used to quantify the needs of ICU patients according to the nursing activities required. Thus, our project, a proof of concept for management and patient outcomes, inspired by convincing international initiatives, proposes to examine the implementation process of a new computerized information system (CIS) based on the Nursing Activities Score (NAS) tool – which makes it possible to identify the nature and intensity of nursing activities in direct care – in the ICUs of the CHU de Québec – UL and the IUCPQ – UL in Quebec City, and to analyze the contribution of these data in understanding patient outcomes and cost per patient. The implementation of such a system will provide data that can guide decisions and management strategies that are still made arbitrarily in Quebec. Similarly, patient-cost evaluations will contribute to cost estimates based on the care trajectory. These actions will optimize the use of human and financial resources in ICUs.