| Title |
Are high nurse workload/staffing ratios associated with decreased survival in critically ill patients? A cohort study
|
|---|---|
| Published in |
Annals of Intensive Care, May 2017
|
| DOI | 10.1186/s13613-017-0269-2 |
| Pubmed ID | |
| Authors |
Anna Lee, Yip Sing Leo Cheung, Gavin Matthew Joynt, Czarina Chi Hung Leung, Wai-Tat Wong, Charles David Gomersall |
| Abstract |
Despite the central role of nurses in intensive care, a relationship between intensive care nurse workload/staffing ratios and survival has not been clearly established. We determined whether there is a threshold workload/staffing ratio above which the probability of hospital survival is reduced and then modeled the relationship between exposure to inadequate staffing at any stage of a patient's ICU stay and risk-adjusted hospital survival. Retrospective analysis of prospectively collected data from a cohort of adult patients admitted to two multi-disciplinary Intensive Care Units was performed. The nursing workload [measured using the Therapeutic Intervention Scoring System (TISS-76)] for all patients in the ICU during each day to average number of bedside nurses per shift on that day (workload/nurse) ratio, severity of illness (using Acute Physiology and Chronic Health Evaluation III) and hospital survival were analysed using net-benefit regression methodology and logistic regression. A total of 894 separate admissions, representing 845 patients, were analysed. Our analysis shows that there was a 95% probability that survival to hospital discharge was more likely to occur when the maximum workload-to-nurse ratio was <40 and a more than 95% chance that death was more likely to occur when the ratio was >52. Patients exposed to a high workload/nurse ratio (≥52) for ≥1 day during their ICU stay had lower risk-adjusted odds of survival to hospital discharge compared to patients never exposed to a high ratio (odds ratio 0.35, 95% CI 0.16-0.79). Exposing critically ill patients to high workload/staffing ratios is associated with a substantial reduction in the odds of survival. |
X Demographics
The data shown below were collected from the profiles of 27 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 12 | 44% |
| Australia | 3 | 11% |
| Canada | 1 | 4% |
| United Kingdom | 1 | 4% |
| Unknown | 10 | 37% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Practitioners (doctors, other healthcare professionals) | 12 | 44% |
| Members of the public | 12 | 44% |
| Scientists | 3 | 11% |
Mendeley readers
The data shown below were compiled from readership statistics for 194 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 194 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 42 | 22% |
| Student > Bachelor | 27 | 14% |
| Student > Ph. D. Student | 14 | 7% |
| Researcher | 13 | 7% |
| Other | 9 | 5% |
| Other | 32 | 16% |
| Unknown | 57 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Nursing and Health Professions | 72 | 37% |
| Medicine and Dentistry | 25 | 13% |
| Engineering | 7 | 4% |
| Business, Management and Accounting | 4 | 2% |
| Pharmacology, Toxicology and Pharmaceutical Science | 4 | 2% |
| Other | 21 | 11% |
| Unknown | 61 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 47. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 September 2023.
All research outputs
#901,255
of 25,498,750 outputs
Outputs from Annals of Intensive Care
#98
of 1,200 outputs
Outputs of similar age
#18,131
of 325,206 outputs
Outputs of similar age from Annals of Intensive Care
#2
of 33 outputs
Altmetric has tracked 25,498,750 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 96th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,200 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 18.3. This one has done particularly well, scoring higher than 91% of its peers.
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We're also able to compare this research output to 33 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 96% of its contemporaries.