Index of Caring Complexity as a management tool in a surgical setting: an observational study

Among different methods of nursing classification, the Index of Caring Complexity (ICC) is a management tool to evaluate appropriateness of nursing procedures, integrate health-care support workers and to monitor the need of nursing staff. The objective of this observational study was to apply the ICC method in a surgical ward of the Marche Region (Italy), to determine the nursing staff level. METHODS: From 1 January to 30 April 2010, all data of patients admitted for more than 48 hours were collected. The determination of nursing staff level derived from the five patient classification on the basis of the complexity/gravity "scores" of data flow obtained during the caring process. RESULTS: The ICC method showed a staffing of 11 nurses: a staff shortage of three nurse, if compared to the actual staff. The ICC method also demonstrate its strength as a useful tool to reorganize care. The ICA showed that the most frequent nursing activities :"Apply postures to facilitate breathing "(83%),"Prepare/provide appropriate foods in temperature/texture/quantity "(100%); "Providing aids for elimination needs" (80.7%); "Help in dressing" (82.7%); "Transfer from stretcher to bed" (83.4%); "Remaking bed/unit sick" (100%); "Monitoring of vital signs" (100%); "Health Education" (100%); "Nursing Assessment" (100%); "Management and treatment of intravascular devices" (100%); "Performing instrumental exams". CONCLUSIONS: Assess the most frequent nursing activities, allows: to better distribute activities among professionals, identify nurses' competencies and activities to be prescribed to health-care support workers.