The fewer patients an ICU nurse has to juggle, the better those patients’ chances of making it out of the hospital alive, according to a large observational study published in Critical Care Medicine. Data from the large EPIC II study suggested that two patients per nurse may be too many for safe, high-quality critical care. Nurse-to-patient ratios above 1:1.5 (meaning fewer than 3 patients per 2 nurses, on average) were independently associated with a lower risk for death (odds ratio of 0.71) compared to when each nurse cared for 2 patients. The Extended Prevalence of Infection in Intensive Care (EPIC II) study in 2007 collected data from more than 1,200 ICUs in 75 countries (most in Europe and North America), twice a day, at 10 am and 10 pm. More than half were university teaching hospitals; ICU mortality was 18%. In the U.S. and Canada, the nurse-to-patient ratio stayed close to 1:1.5 at both time points. Western Europe and Latin America had lower nurse staffing, especially at night, with an overall ratio of ~1:1.8. But the U.S. hardly led the field in ICU nursing staffing, coming in behind most of Eastern Europe and Asia (which approached a 1:1 nurse to patient ratio overall). "Time constraints related to a reduced nurse to patient ratio may increase the likelihood of mistakes by creating a stressful environment with distractions and interruptions that adversely affect quality of care,” authors hypothesized. Reporting was voluntary, so authors also warned of selection bias. The finding is statistically robust, but it's still hard to draw conclusions across different national health systems. For example, in many countries outside the U.S., nurses perform the duties of a respiratory therapist. The study correlates with
Is more than one patient per ICU nurse dangerous?
Is more than one patient per ICU nurse…
Is more than one patient per ICU nurse dangerous?
The fewer patients an ICU nurse has to juggle, the better those patients’ chances of making it out of the hospital alive, according to a large observational study published in Critical Care Medicine. Data from the large EPIC II study suggested that two patients per nurse may be too many for safe, high-quality critical care. Nurse-to-patient ratios above 1:1.5 (meaning fewer than 3 patients per 2 nurses, on average) were independently associated with a lower risk for death (odds ratio of 0.71) compared to when each nurse cared for 2 patients. The Extended Prevalence of Infection in Intensive Care (EPIC II) study in 2007 collected data from more than 1,200 ICUs in 75 countries (most in Europe and North America), twice a day, at 10 am and 10 pm. More than half were university teaching hospitals; ICU mortality was 18%. In the U.S. and Canada, the nurse-to-patient ratio stayed close to 1:1.5 at both time points. Western Europe and Latin America had lower nurse staffing, especially at night, with an overall ratio of ~1:1.8. But the U.S. hardly led the field in ICU nursing staffing, coming in behind most of Eastern Europe and Asia (which approached a 1:1 nurse to patient ratio overall). "Time constraints related to a reduced nurse to patient ratio may increase the likelihood of mistakes by creating a stressful environment with distractions and interruptions that adversely affect quality of care,” authors hypothesized. Reporting was voluntary, so authors also warned of selection bias. The finding is statistically robust, but it's still hard to draw conclusions across different national health systems. For example, in many countries outside the U.S., nurses perform the duties of a respiratory therapist. The study correlates with