The Nursing Activities Score Per Nurse Ratio Is Associated With In-Hospital Mortality, Whereas the Patients Per Nurse Ratio Is Not.

Abstract:

OBJECTIVES:Studies have shown contradicting results on the association of nursing workload and mortality. Most of these studies expressed workload as patients per nurse ratios; however, this does not take into account that some patients require more nursing time than others. Nursing time can be quantified by tools like the Nursing Activities Score. We investigated the association of the Nursing Activities Score per nurse ratio, respectively, the patients per nurse ratio with in-hospital mortality in ICUs. DESIGN:Retrospective analysis of the National Intensive Care Evaluation database. SETTING:Fifteen Dutch ICUs. PATIENTS:All ICU patients admitted to and registered ICU nurses working at 15 Dutch ICUs between January 1, 2016, and January 1, 2018, were included. The association of mean or day 1 patients per nurse ratio and Nursing Activities Score per nurse ratio with in-hospital mortality was analyzed using logistic regression models. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:Nursing Activities Score per nurse ratio greater than 41 for both mean Nursing Activities Score per nurse ratio as well as Nursing Activities Score per nurse ratio on day 1 were associated with a higher in-hospital mortality (odds ratios, 1.19 and 1.17, respectively). After case-mix adjustment the association between a Nursing Activities Score per nurse ratio greater than 61 for both mean Nursing Activities Score per nurse ratio as well as Nursing Activities Score per nurse ratio on day 1 and in-hospital mortality remained significant (odds ratios, 1.29 and 1.26, respectively). Patients per nurse ratio was not associated with in-hospital mortality. CONCLUSIONS:A higher Nursing Activities Score per nurse ratio was associated with higher in-hospital mortality. In contrast, no association was found between patients per nurse ratios and in-hospital mortality in The Netherlands. Therefore, we conclude that it is more important to focus on the nursing workload that the patients generate rather than on the number of patients the nurse has to take care of in the ICU.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Margadant C,Wortel S,Hoogendoorn M,Bosman R,Spijkstra JJ,Brinkman S,de Keizer N

doi

10.1097/CCM.0000000000004005

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

3-9

issue

1

eissn

0090-3493

issn

1530-0293

pii

00003246-202001000-00002

journal_volume

48

pub_type

杂志文章
  • Granulocyte colony-stimulating factor improves survival rate and reduces concentrations of bacteria, endotoxin, tumor necrosis factor, and endothelin-1 in fulminant intra-abdominal sepsis in rats.

    abstract:OBJECTIVE:To study the therapeutic effect of granulocyte colony-stimulating factor (G-CSF) on the mortality rate and host defense pattern in fulminant intra-abdominal sepsis. DESIGN:Prospective, randomized, controlled trial. SETTING:Research laboratory in a university hospital. SUBJECTS:Adult male Wistar rats. INTE...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199605000-00016

    authors: Lundblad R,Nesland JM,Giercksky KE

    更新日期:1996-05-01 00:00:00

  • Dysphagia in Mechanically Ventilated ICU Patients (DYnAMICS): A Prospective Observational Trial.

    abstract:OBJECTIVES:Swallowing disorders may be associated with adverse clinical outcomes in patients following invasive mechanical ventilation. We investigated the incidence of dysphagia, its time course, and association with clinically relevant outcomes in extubated critically ill patients. DESIGN:Prospective observational t...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000002765

    authors: Schefold JC,Berger D,Zürcher P,Lensch M,Perren A,Jakob SM,Parviainen I,Takala J

    更新日期:2017-12-01 00:00:00

  • Management of subcutaneous emphysema, pneumomediastinum, and pneumothorax during respirator therapy.

    abstract::Pulmonary barotrauma developed in 18/430 patients receiving respirator support for longer than 12 hours. Pneumothorax occurred in 15 of these patients and was treated with tube thoracostomy and 15-20 cm H2O pleural suction. Full reexpansion of the lungs were achieved in all but three patients, two of whom had bronchop...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-197503000-00004

    authors: Zimmerman JE,Dunbar BS,Klingenmaier CH

    更新日期:1975-03-01 00:00:00

  • Dopamine versus norepinephrine in the treatment of septic shock: a meta-analysis*.

    abstract:OBJECTIVES:There has long-been controversy about the possible superiority of norepinephrine compared to dopamine in the treatment of shock. The objective was to evaluate the effects of norepinephrine and dopamine on outcome and adverse events in patients with septic shock. DATA SOURCES:A systematic search of the MEDLI...

    journal_title:Critical care medicine

    pub_type: 杂志文章,meta分析

    doi:10.1097/CCM.0b013e31823778ee

    authors: De Backer D,Aldecoa C,Njimi H,Vincent JL

    更新日期:2012-03-01 00:00:00

  • Neuroprotective effects of argon in an in vivo model of transient middle cerebral artery occlusion in rats.

    abstract:OBJECTIVE:The neuroprotective effects of the noble gas xenon are well known. Argon, in contrast to xenon, is abundant, inexpensive, and therefore widely applicable. In this study, we analyzed the possible neuroprotective role of argon in an in vivo rat model of acute focal cerebral ischemia. DESIGN:Controlled laborato...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e31821209be

    authors: Ryang YM,Fahlenkamp AV,Rossaint R,Wesp D,Loetscher PD,Beyer C,Coburn M

    更新日期:2011-06-01 00:00:00

  • Central Venous-to-Arterial PCO2 Difference and Central Venous Oxygen Saturation in the Detection of Extubation Failure in Critically Ill Patients.

    abstract:OBJECTIVES:To evaluate the ability of central venous-to-arterial carbon dioxide pressure difference, central venous oxygen saturation, and the combination of these two parameters to detect extubation failure in critically ill patients. DESIGN:Multicentric, prospective, observational study. SETTING:Three ICUs. PATIEN...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000004446

    authors: Mallat J,Baghdadi FA,Mohammad U,Lemyze M,Temime J,Tronchon L,Thevenin D,Fischer MO

    更新日期:2020-10-01 00:00:00

  • Dimethyl-prostaglandin E2 prevents stress ulceration with minimal complications.

    abstract::Gastric mucosal damage produced by topical application of necrotizing agents is diminished by topical or systemic pretreatment with a variety of E and F prostaglandins. The rat restraint model of gastric mucosal injury is more analogous to clinical stress ulceration than are models using intragastric application of to...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198901000-00011

    authors: Ephgrave KS,Horton J,Burns D

    更新日期:1989-01-01 00:00:00

  • Experience of diffusion tensor imaging and 1H spectroscopy for outcome prediction in severe traumatic brain injury: Preliminary results.

    abstract:OBJECTIVE:The objective of the study is to test whether multimodal magnetic resonance imaging can provide a reliable outcome prediction of the clinical status, focusing on consciousness at 1 year after severe traumatic brain injury (TBI). DESIGN:Single center prospective cohort with consecutive inclusions. SETTING:Cr...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e31819cf050

    authors: Tollard E,Galanaud D,Perlbarg V,Sanchez-Pena P,Le Fur Y,Abdennour L,Cozzone P,Lehericy S,Chiras J,Puybasset L

    更新日期:2009-04-01 00:00:00

  • Empiric treatment of hospital-acquired lower respiratory tract infections with meropenem or ceftazidime with tobramycin: a randomized study. Meropenem Lower Respiratory Infection Group.

    abstract:OBJECTIVE:To evaluate the efficacy and tolerability of intravenous empiric treatment with meropenem compared with ceftazidime-tobramycin in patients with hospital-acquired lower respiratory tract infections. DESIGN:Prospective, nonblind, randomized trial. SETTING:Multicenter trial conducted at 22 centers. PATIENTS:T...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00003246-199710000-00015

    authors: Sieger B,Berman SJ,Geckler RW,Farkas SA

    更新日期:1997-10-01 00:00:00

  • New Insights Into Multicenter PICU Mortality Among Pediatric Hematopoietic Stem Cell Transplant Patients.

    abstract:OBJECTIVES:Over 2,500 children undergo hematopoietic stem cell transplantation in the United States each year, and up to 35% require PICU support for life-threatening complications. PICU mortality has dropped from 85% to 44%, but interpretation is confounded by significant cohort heterogeneity. Reports conflict regardi...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/CCM.0000000000001085

    authors: Zinter MS,Dvorak CC,Spicer A,Cowan MJ,Sapru A

    更新日期:2015-09-01 00:00:00

  • Phenotyping the Immune Response to Trauma: A Multiparametric Systems Immunology Approach.

    abstract:OBJECTIVE:Trauma induces a complex immune response that requires a systems biology research approach. Here, we used a novel technology, mass cytometry by time-of-flight, to comprehensively characterize the multicellular response to trauma. DESIGN:Peripheral blood mononuclear cells samples were stained with a 38-marker...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000002577

    authors: Seshadri A,Brat GA,Yorkgitis BK,Keegan J,Dolan J,Salim A,Askari R,Lederer JA

    更新日期:2017-09-01 00:00:00

  • Delivery of metered dose inhaler aerosols to paralyzed and nonparalyzed rabbits.

    abstract:OBJECTIVE:To assess whether paralysis alters pulmonary deposition of albuterol delivered by metered dose inhaler and spacer to small animals. DESIGN:A parallel group study of intubated and ventilated rabbits. INTERVENTIONS:Animals in group 1 (n = 7) were paralyzed with intravenous pancuronium, and ventilated at a rat...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199701000-00026

    authors: Fok TF,al-Essa M,Monkman S,Dolovich M,Girard L,Coates G,Kirpalani H

    更新日期:1997-01-01 00:00:00

  • Oxygen saturation determined from deep muscle, not thenar tissue, is an early indicator of central hypovolemia in humans.

    abstract:OBJECTIVE:To compare the responses of noninvasively measured tissue oxygen saturation (StO2) and calculated muscle oxygen tension (PmO2) to standard hemodynamic variables for early detection of imminent hemodynamic instability during progressive central hypovolemia in humans. DESIGN:Prospective study. SETTING:Researc...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000295586.83787.7E

    authors: Soller BR,Ryan KL,Rickards CA,Cooke WH,Yang Y,Soyemi OO,Crookes BA,Heard SO,Convertino VA

    更新日期:2008-01-01 00:00:00

  • Intralipid disappearance in critically ill patients.

    abstract::Intralipid elimination patterns were compared in 25 healthy controls, 12 patients recovering from uncomplicated cholecystectomy, and 25 critically ill patients. The intravenous fat tolerance test revealed a similar fractional removal rate (k2) in healthy controls and critically ill patients, but k2 was increased in ch...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198605000-00009

    authors: Lindh A,Lindholm M,Rössner S

    更新日期:1986-05-01 00:00:00

  • The significance of hypoxemia with low inspired O2 fraction before extubation.

    abstract::Arterial and transcutaneous O2 (PtcO2) and CO2 (PtcCO2) tensions, arterial O2 saturations (SaO2) and P50 values were measured in 47 patients before extubation. In order to unmask ventilation to perfusion (VA/Q) inequality, all variables were obtained without CPAP and with FIO2 of 0.40 as well as with CPAP of 5 cm H2O ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198309000-00007

    authors: Tahvanainen J,Nikki P

    更新日期:1983-09-01 00:00:00

  • Methylprednisolone inhibits low-flow hypoxia-induced mitochondrial dysfunction in isolated perfused rat liver.

    abstract:OBJECTIVE:To investigate the mechanism by which methylprednisolone protects the liver from hypoxia-induced injury. DESIGN:Prospective control study using the isolated rat liver. SETTING:Animal research facility. SUBJECTS:Male, fasted, pathogen-free Sprague-Dawley rats. INTERVENTIONS:Low-flow hypoxia was produced by...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000066176.49774.CC

    authors: Motoyama S,Saito S,Minamiya Y,Saito R,Nakamura M,Okuyama M,Imano H,Ogawa J

    更新日期:2003-05-01 00:00:00

  • Death in the ICU: does the patient predict his own demise?

    abstract::Critically ill patients who fear impending death may die suddenly. We studied prospectively the incidence of death in critically ill surgical patients who articulated the fear that they were about to die. Physiologic, environmental, and behavioral correlates which might influence perceptions of impending death were ex...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198607000-00005

    authors: Poulton TJ,Butdorf MB

    更新日期:1986-07-01 00:00:00

  • A potential role of hyperbaric oxygen exposure through intestinal nuclear factor-kappaB.

    abstract:OBJECTIVE:Recent studies have demonstrated the therapeutic effectiveness and pharmacologic mechanisms of hyperbaric oxygen therapy (HBOT) in the treatment of a systemic shock state. To elucidate the in vivo role of HBOT during sepsis, we evaluated the effects of HBOT on intestinal mucosal injury and bacterial transloca...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.ccm.0000132898.27101.6c

    authors: Sakoda M,Ueno S,Kihara K,Arikawa K,Dogomori H,Nuruki K,Takao S,Aikou T

    更新日期:2004-08-01 00:00:00

  • Assessment of patients' experience of discomforts during respirator therapy.

    abstract::Patients (n = 158) who had been respirator-treated and who could remember the treatment were retrospectively (after greater than 2 months) interviewed about their experiences. Of all patients, 47% had felt anxiety and/or fear during the treatment. These feelings were intimately related to the experience of agony/panic...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198910000-00021

    authors: Bergbom-Engberg I,Haljamäe H

    更新日期:1989-10-01 00:00:00

  • Timing and predictors of death in pediatric patients with multiple organ system failure.

    abstract:OBJECTIVES:To describe the timing of onset of organ system failure, multiple organ system failure diagnosis, and the subsequent death in children admitted to a pediatric intensive care unit (ICU). Second, to identify independent risk markers of death in pediatric patients with multiple organ system failure. DESIGN:Rev...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199406000-00023

    authors: Proulx F,Gauthier M,Nadeau D,Lacroix J,Farrell CA

    更新日期:1994-06-01 00:00:00

  • Recombinant human erythropoietin pretreatment attenuates acute renal tubular injury against ischemia-reperfusion by restoring transient receptor potential channel-6 expression and function in collecting ducts.

    abstract:OBJECTIVE:Acute renal tubular injury is a serious complication in the postoperative period, which is associated with high mortality and increased ICU stay. We aimed to demonstrate the protective effect of rhEPO against acute tubular injury induced by ischemia-reperfusion and to explore the mechanism of canonical transi...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000000542

    authors: Shen S,Jin Y,Li W,Liu X,Zhang T,Xia W,Wang Y,Ma K

    更新日期:2014-10-01 00:00:00

  • L-arginine: nitric oxide pathway in endotoxemia and human septic shock.

    abstract:OBJECTIVE:To investigate the relationship between nitric oxide production, endotoxemia, and hemodynamic alterations in human septic shock. DESIGN:Prospective study. SETTING:A 32-bed intensive care unit in a university referral hospital. PATIENTS:Two groups of septic patients with shock (n = 13) or without shock (n =...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199502000-00009

    authors: Gómez-Jiménez J,Salgado A,Mourelle M,Martín MC,Segura RM,Peracaula R,Moncada S

    更新日期:1995-02-01 00:00:00

  • Lower hospital mortality and complications after pediatric hematopoietic stem cell transplantation.

    abstract:OBJECTIVE:To assess protective and risk factors for mortality among pediatric patients during initial care after hematopoietic stem cell transplantation (HSCT) and to evaluate changes in hospital mortality. DESIGN:Retrospective cohort using the 1997, 2000, and 2003 Kids Inpatient Database, a probabilistic sample of ch...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0B013E318161FAC1

    authors: Bratton SL,Van Duker H,Statler KD,Pulsipher MA,McArthur J,Keenan HT

    更新日期:2008-03-01 00:00:00

  • Lithium dilution cardiac output measurement: a comparison with thermodilution.

    abstract:OBJECTIVE:To compare the results of cardiac output measurements obtained by lithium dilution and thermodilution. DESIGN:Case series, observational study. SETTING:High-dependency postoperative unit and intensive care unit of a teaching hospital. PATIENTS:Forty patients were studied. Thirty-four patients had undergoin...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1097/00003246-199711000-00015

    authors: Linton R,Band D,O'Brien T,Jonas M,Leach R

    更新日期:1997-11-01 00:00:00

  • The effect of hypermetabolism induced by burn trauma on the ethanol-oxidizing capacity of the liver.

    abstract:OBJECTIVE:To study the rate of elimination of ethanol after a major burn trauma. DESIGN:Prospective, controlled study. SETTING:National burns unit in a Swedish university hospital. PATIENTS AND SUBJECTS:Eight consecutive patients suffering from 18%-72% total burned surface area and nine healthy male control subjects...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1097/00003246-199912000-00003

    authors: Zdolsek HJ,Sjöberg F,Lisander B,Jones AW

    更新日期:1999-12-01 00:00:00

  • Protection of Brain Injury by Amniotic Mesenchymal Stromal Cell-Secreted Metabolites.

    abstract:OBJECTIVES:To define the features of human amniotic mesenchymal stromal cell secretome and its protective properties in experimental models of acute brain injury. DESIGN:Prospective experimental study. SETTING:Laboratory research. SUBJECTS:C57Bl/6 mice. INTERVENTIONS:Mice subjected to sham or traumatic brain injury...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000001864

    authors: Pischiutta F,Brunelli L,Romele P,Silini A,Sammali E,Paracchini L,Marchini S,Talamini L,Bigini P,Boncoraglio GB,Pastorelli R,De Simoni MG,Parolini O,Zanier ER

    更新日期:2016-11-01 00:00:00

  • Coping Strategies and Posttraumatic Stress Symptoms in Post-ICU Family Decision Makers.

    abstract:OBJECTIVE:To assess the coping strategies used by family decision makers of adult critical care patients during and after the critical care experience and the relationship of coping strategies to posttraumatic stress symptoms experienced 60 days after hospitalization. DESIGN:A single-group descriptive longitudinal cor...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000000934

    authors: Petrinec AB,Mazanec PM,Burant CJ,Hoffer A,Daly BJ

    更新日期:2015-06-01 00:00:00

  • Soluble triggering receptor expressed on myeloid cells-1 as an infection marker for patients with neutropenic fever.

    abstract:OBJECTIVE:To assess the value of soluble triggering receptor expressed on myeloid cells-1 as a biomarker of infection in patients with neutropenic fever comparing with procalcitonin and C-reactive protein. DESIGN:Prospective, comparative, single-center study. SETTING:Hematology ward at a university hospital. SUBJECT...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e31820a92dc

    authors: Lin CH,Yao M,Hsu SC,Ho CC,Lin MT,Lin CA,Hu FC,Yu CJ,Tien HF

    更新日期:2011-05-01 00:00:00

  • Transient coagulation abnormalities after incompatible blood transfusion.

    abstract::This report describes an unusual hemolytic transfusion reaction. A group O donor was inadvertently transfused with 100 ml of group A red cells during the course of plasmapheresis. Granulocytopenia, thrombocytopenia, hypofibrinogenemia and low levels of factors V, VIII, and IX developed immediately after the infusion. ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-197501000-00003

    authors: McKenna PJ,Scheinman HZ

    更新日期:1975-01-01 00:00:00

  • Neurologic disorders in pregnancy.

    abstract:BACKGROUND:Neurologic dysfunction, coma, and seizures are common in obstetric patients in the intensive care unit. OBJECTIVE:To review common neurologic disorders resulting in critical illness in pregnancy. REVIEW:Obstetric disorders causing coma and seizures include eclampsia, acute fatty liver of pregnancy, and amn...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/01.ccm.0000182790.35728.f7

    authors: Karnad DR,Guntupalli KK

    更新日期:2005-10-01 00:00:00