Nurse-to-Nurse Familiarity and Mortality in the Critically Ill: A Multicenter Observational Study.
Am J Respir Crit Care Med
; 207(8): 1022-1029, 2023 04 15.
Article
in En
| MEDLINE
| ID: mdl-36219472
ABSTRACT
Rationale Nurse-to-nurse familiarity at work should strengthen the components of teamwork and enhance its efficiency. However, its impact on patient outcomes in critical care remains poorly investigated. Objectives:
To explore the role of nurse-to-nurse familiarity on inpatient deaths during ICU stay.Methods:
This was a retrospective observational study in eight adult academic ICUs between January 1, 2011 and December 31, 2016. Measurements and MainResults:
Nurse-to-nurse familiarity was measured across day and night 12-hour daily shifts as the mean number of previous collaborations between each nursing team member during previous shifts within the given ICU (suboptimal if <50). Primary outcome was a shift with at least one inpatient death, excluding death of patients with a decision to forego life-sustaining therapy. A multiple modified Poisson regression was computed to identify the determinants of mortality per shift, taking into account ICU, patient characteristics, patient-to-nurse and patient-to-assistant nurse ratios, nurse experience length, and workload. A total of 43,479 patients were admitted, of whom 3,311 (8%) died. The adjusted model showed a lower risk of a shift with mortality when nurse-to-nurse familiarity increased in the shift (relative risk, 0.90; 95% confidence interval per 10 shifts, 0.82-0.98; P = 0.012). Low nurse-to-nurse familiarity during the shift combined with suboptimal patient-to-nurse and patient-to-assistant nurse ratios (suboptimal if >2.5 and >4, respectively) were associated with increased risk of shift with mortality (relative risk, 1.84; 95% confidence interval, 1.15-2.96; P < 0.001).Conclusions:
Shifts with low nurse-to-nurse familiarity were associated with an increased risk of patient deaths.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Personnel Staffing and Scheduling
/
Critical Illness
Type of study:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
Limits:
Adult
/
Humans
Language:
En
Journal:
Am J Respir Crit Care Med
Journal subject:
TERAPIA INTENSIVA
Year:
2023
Document type:
Article
Affiliation country:
Francia