Objective: To describe nursing care intensity using the Nursing Activities Score (NAS), the patient-to-nurse ratio by shift, and mean NAS according to selected clinical factors at the Intensive Care and Poison Control Department, 19-8 Hospital, Ministry of Public Security.
Methods: A prospective descriptive study with repeated cross-sectional assessments was completed from January to May 2026. Three non-consecutive observation days were selected each month, including two working days and one weekend or holiday, resulting in 15 observation days. All eligible patient-days were assessed using NAS over a 24-hour cycle. Patient numbers and direct-care nurses were recorded during administrative and on-duty/off-hour periods. The study included 361 patient-days and 30 shift-level observations. Clinical-factor comparisons were exploratory and were not interpreted causally.
Results: The mean number of patients per observation day was 24.1 ± 1.3. Mean NAS was 69.8 ± 17.6 points per patient-day (95% CI: 68.0-71.6); 106/361 patient-days (29.4%; 95% CI: 24.9-34.3) had NAS ≥ 80. The mean patient-to-nurse ratio was 2.7 ± 0.3 during administrative periods (95% CI: 2.5-2.9) and 6.4 ± 0.7 during on-duty/off-hour periods (95% CI: 6.0-6.8). Thirteen of 15 on-duty/off-hour observations (86.7%; 95% CI: 62.1-96.3) had a ratio of at least six patients per nurse. Mean NAS was higher among patient-days involving mechanical ventilation, vasopressor use, renal replacement therapy, an artificial airway, or at least two intensive care interventions (p < 0.001).
Conclusion: The study documented substantial nursing care requirements and a clear difference in patient-to-nurse ratios between work periods. These descriptive findings may support internal review of care organization; they are insufficient to establish staffing inadequacy or causal effects on patient outcomes.