מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – Having fewer nurses in the intensive care unit (ICU) at night is associated with more patient complications and increased costs, according to a report in the November issue of the American Journal of Critical Care.
Dr. Justin B. Dimick and colleagues from Johns Hopkins University, Baltimore, collected data on 569 patients who were in the ICU after undergoing hepatic resection. The researchers defined fewer nurses at night as having one nurse for three or more patients and having more nurses as one nurse for one or two patients.
Among these patients, 240 had fewer nurses at 25 hospitals, while 316 had more nurses at eight hospitals. There was no significant link between nurse-to-patient ratio and in-hospital mortality, the researchers report.
Multivariate analysis showed that patients with fewer nurses were at increased risk for reintubation (odds ratio 2.9, p = 0.04) and incurred a 14% ($1248) increase in hospital costs (p = 0.007), Dr. Dimick's team found.
"The results are important because they indicate that a relatively straightforward change in health policy…is practically achievable and most likely would improve both clinical and economic outcomes for postoperative patients," the researchers say.
"Moreover, the direct impact of the availability of critical care nurses now and in the near future might have great importance in measuring direct outcomes of patients," Dr. Dimick and colleagues conclude.
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