Nursing Workload and Functional Autonomy in Patients With Acute Heart Failure Admitted to the Cicu: The Prospective Observational Precardio Study

Background Acute heart failure is one of the leading causes of admission to Cardiac Intensive Care Units (CICU) and is associated with high nursing workload, clinical frailty, and reduced functional autonomy. However, structured indicators of nursing workload and functional status are not routinely integrated into decision–making processes at the time of transfer or discharge. Aim To describe nursing workload and functional autonomy in patients admitted to the CICU for acute heart failure and to analyze their association with organizational outcomes and discharge destination. Methods This is a single–center, prospective observational study initiated in October 2025 and currently ongoing. Adult patients admitted for acute heart failure with a BRASS score ≥11 and a Barthel Index ≤90 at admission are enrolled after informed consent. Nursing workload is assessed using the Nursing Activities Score (NAS), while frailty and functional autonomy are evaluated through the BRASS Index and the Barthel Index. Assessments are performed within 24 hours of admission and at the time of transfer or discharge. Essential clinical data and discharge destination are collected. The analysis includes descriptive statistics and evaluation of associations between nursing workload, functional indicators, and organizational outcomes. Preliminary results Preliminary analyses highlight marked heterogeneity in care profiles, with a subset of patients characterized by high nursing workload and reduced functional autonomy, frequently associated with complex discharge pathways and increased need for structured continuity of care. Conclusions The PRECARDIO study suggests that the systematic integration of nursing workload and functional autonomy indicators in the CICU may support more appropriate transfer planning, improve continuity of care, and contribute to the development of more efficient organizational models in acute heart failure.