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Postoperative complications: does intensive care unit staff nursing make a difference?

Deborah Dang·Mary E Johantgen·Peter J Pronovost·Mollie W Jenckes·Eric B Bass
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Abstract

OBJECTIVE: The purpose of this study was to examine the association between intensive care unit nurse (ICU) staffing and the likelihood of complications for patients undergoing abdominal aortic surgery. DESIGN: The study is a retrospective review of hospital discharge data linked to data on ICU organizational characteristics. SETTING: Research took place in ICUs in non-federal, short-stay hospitals in Maryland. PATIENTS: Study included 2606 patients undergoing abdominal aortic surgery in Maryland between January 1994 and December 1996. OUTCOME MEASURES: Outcome measures included cardiac, respiratory, and other complications. RESULTS: Cardiac complications occurred in 13% of patients, respiratory complications occurred in 30%, and other complications occurred in 8% of patients. Multiple logistic regression revealed a statistically significant increased likelihood of respiratory complications (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.50-3.60) in abdominal aortic surgery patients cared for in ICUs with low- versus high-intensity nurse staffing, an increased likelihood of cardiac complications (OR, 1.78; CI, 1.16-2.72) and other complications (OR, 1.74; CI, 1.15-2.63) in ICUs with medium- versus high-intensity nurse staffing, after controlling for patient and organizational characteristics. CONCLUSIONS: Within the range of ICU nurse staffing levels present in Maryland hospitals, decreased nurse staffing was significantly associated with an increased risk of complications in patients undergoing abdominal aortic surgery.

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AdultAgedAged, 80 and overAorta, AbdominalFemaleHumansIntensive Care UnitsLength of StayMaleMarylandMiddle AgedNursing Staff, HospitalOutcome and Process Assessment, Health CarePersonnel Staffing and SchedulingPostoperative ComplicationsProbabilityRetrospective StudiesRisk AssessmentWorkforceJournal Article

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Deborah Dang, Mary E Johantgen, Peter J Pronovost, Mollie W Jenckes, Eric B Bass. Postoperative complications: does intensive care unit staff nursing make a difference?. https://doi.org/10.1067/mhl.2002.122838

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