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Korean Society of Muscle and Joint Health (대한근관절건강학회)
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Analysis of Factors Related to Mortality in Adult ICU Patients: Focusing on Nurse Staffing Level

성인중환자실 이용 환자의 사망률 관련 요인 분석: 간호등급을 중심으로

  • Lee, Jeong Mo (Division of Pulmonology and Department of Internal Medicine, National Health Insurance Service Ilsan Hospital) ;
  • Lee, Kwang Ok (Department of Nursing, Sangmyung University) ;
  • Hong, Jeong Hwa (Research and Analysis, National Health Insurance Service Ilsan Hospital) ;
  • Park, Hyun Hee (Operation Nursing, National Health Insurance Service Ilsan Hospital)
  • 이정모 (국민건강보험 일산병원 호흡기내과 집중치료실) ;
  • 이광옥 (상명대학교 간호학과) ;
  • 홍정화 (국민건강보험 일산병원 연구분석부) ;
  • 박현희 (국민건강보험 일산병원 수술간호부)
  • Received : 2022.04.08
  • Accepted : 2022.04.15
  • Published : 2022.04.30
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Abstract

Purpose: The purpose of this study was to assess the influence of nurses staffing level on patient health outcomes in intensive care units (ICUs) in Korea. Methods: The study was retrospective in nature. Information on patients and their outcomes, as well as nurse cohort data, were obtained from Korea's National Health Insurance Service Database. The observation period was from January 1, 2008 to December 31, 2018, and data for 2,964,991 patients were analyzed. Independent variables included patient' age and sex and hospital type, intensivist, and nurses staffing level. Results: The mortality rate in ICUs was significantly higher at tertiary hospitals with a level 3~4 (HR, 1.21; 95% confidence interval, 1.19~1.22) or level 5~9 nurse staffing (HR, 1.31; 95% confidence interval, 1.27~1.34) compare to that of tertiary hospitals with a 1~2 level. 28-day mortality rate was also higher at general hospitals with a level 3~4 (HR, 1.13; 95% confidence interval, 1.12~1.14), level 5~6 (HR. 1.34; 95% confidence interval, 1.32~1.36), level 7~9 nurse staffing (HR, 1.38; 95% confidence interval, 1.38~1.42), using level 1~2 as reference. Conclusion: Nurses staffing level is a key determinant of healthcare-associated mortality in critically ICUs patients. Policies to achieve adequate nurse staffing levels are therefore required to enhance patient outcomes.

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References

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