and to estimate the effect of the Nursing Activities Score on the response time of the users to the alarms of the multiparameter monitors. Methods: Cross-sectional, observational study with open cohort performed in a 10-bed intensive care unit, where the timing of alarms triggered by the multiparameter monitors that presented clinical alteration was timed. Patients who were receiving cardiopulmonary resuscitation maneuvers were excluded. The ethical premises were respected. The data were analyzed in statistical software R version x 64 3.1.1. Descriptive statistics, logistic regression analysis, and survival analysis were used. Results: 254 alarms were triggered, where 11% were attended and 89% presented alarm fatigue, totaling 168 hours of observa- tion. The average number of alarms triggered was 4.5 alarms / day with average user time of 64 seconds. The Nursing Activities Score average was 59.2. An association was evidenced of the alarms attended with the complexity of the patient (P b .05), with an increase of almost 5% in the chance of attendance at each point increase in the value of Nursing Activities Score. It was also estimated that at each point of the Nursing Activities Score, the alarm has a 4% chance of being attended to every second (P b .05). Conclusion: The Nursing Activities Score is directly related to the response time to alarms triggered by multiparameter monitors. https://doi.org/10.1016/j.jcrc.2017.09.096 Nurse/patient ratio increase and the impact on health care quality and cost in a center of a public hospital intensive care and teaching Andreza Werli-Alvarenga a , Fernando Antônio Botoni b , Daniela Mascarenhas de Paula a , Edna Marileia Meireles Leite c a Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil b Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil c Hospital Risoleta Tolentino Neves, Belo Horizonte (MG), Brazil Objectives: To estimate the impact on indicators of quality of care and the cost of an intensive care center after the increase in the proportion of nurses per patient. Methods: This is an intervention study. The indicators were evaluated, and cost of a CTI 1 year before and 1 year after the implementation of a care model of proportion of a nurse and a nursing technician for every 3 patients was determined. Previously, the unit of study had a nurse for every 10 patients and a nursing technician for each 1 or 2 patients. We conducted a budget investment for the reorganization of the team. No other intervention or modification of the unit teams occurred during the period in which the indicators were evaluated. Results: There was a reduction with statistical significance (P b .001) of adverse events, such as unplanned extubation, loss of central venous and peripheral access, and loss of enteric probe, among others. Also, the incidence of health care–related infections, such as urinary tract infections, ventilator-associated pneumonia, infection of central venous catheter, and bloodstream infection, among others, features reduction with statistical significance (P b .0002). It was observed that there was a reduction in the average unit cost of 200,000 reais each month after the implementation of the new care model. Conclusion: The nurse/patient ratio increased, and the res- tructuring of the health care model of nursing in intensive care units has an impact in improving the assistance provided and in reducing costs. https://doi.org/10.1016/j.jcrc.2017.09.097 Prevalence and risk factors for burnout syndrome among Brazilian intensive care unit professionals: A multicenter cross-sectional study Regis Goulart Rosa, Renata Kochhann, Rafaela Moraes de Moura, Mariana Martins Siqueira Santos, Daniel Sganzerla, Rodrigo Wiltgen Jeffman, Maicon Oliveira, Cassiano Teixeira Hospital Moinhos de Vento, Porto Alegre (RS), Brazil Objectives: Burnout is defined as a prolonged response to chronic emotional and interpersonal stress on the job. Unfortunately, the literature on risk factors for the development of burnout in the ICU is scarce. The aim of this study was to evaluate the prevalence and factors associated with burnout syndrome among Brazilian ICU professionals. Methods: A multicenter cross-sectional study was performed in mixed medical-surgical Brazilian ICUs from March to May 2017 (part of the cluster-randomized crossover ICU Visits Study). Bedside ICU professionals (intensivists, critical care nurses, nursing technicians, and physiotherapists) with a daytime workload N 20 hours a week were invited to participate in the study. Burnout syndrome was evaluated with the 3-dimensional Maslach Burnout Inventory (MBI): emotional exhaustion, depersonalization, personal accom- plishment, considering cutoff points = 27, = 10, and = 33, respectively. Results: In total, 178 professionals (31 intensivists, 54 critical care nurses, 71 nurse technicians, 22 physiotherapists) from 9 distinct ICUs were evaluated. The mean weekly workload per professional was 44.7 hours (standard deviation, 19.6 hours). The prevalence of burnout was 31.5% (n = 56). The prevalences of lack of personal accomplishment, depersonalization, and emotional exhaustion were 19.1% (n = 34), 14.6% (n = 26), and 13.5% (n = 24), respectively. There was an independent association between previous diagnosis of mood disorder and burnout (prevalence ratio, 3.3; 95% confidence interval, 1.1-10.4). Conclusion: Burnout is a common syndrome among Brazilian ICU professionals. Previous diagnosis of mood disorder is associated with burnout in the ICU setting. https://doi.org/10.1016/j.jcrc.2017.09.098 Improving adequacy of venous thromboembolism prophylaxis with a long-term quality improvement program Selma Regina de Oliveira Raymundo a , Kassim Mohamede Kassim Hussain a , Daniela Orci da Silva Rossetti b , Thais Fuscaldo Lopes b , Ana Claudia Silveira Sales Dias b , Suzana Margareth Ajeje Lobo c a Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto (SP), Brazil b Hospital Austa, São José do Rio Preto (SP), Brazil c Intensive Care Service, Fundação Faculdade Regional de Medicina, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto (SP), Brazil Objectives: To investigate risk factors for venous thromboembolism (VTE) and the adequacy of thromboprophylaxis. Abstracts / Journal of Critical Care 42 (2017) 383–424 401