Kelly, 2012 Adult patients No intervention - No specific 30-day mortality, ICU Retrospective No significant relationship ICU LOS 3e (n=56,826) who used mean comparator and hospital LOS, cross sectional between staffing and were patients per nurse ventilator associated day mortality, hospital mechanically pneumonia, central LOS, central line infection ventilated in ICUs line associated or ventilator associated in 303 hospitals in bloodstream pneumonia - Significant the US infection association between staffing and ICU LOS Adult patients No specific No specific Medication Cross sectional Total hours of nursing care Medication 4b & from 48 ICUs in intervention: comparator administration per patient day was administration errors Blegen, 2009 29 hospitals in Used total hours errors, falls, skin positively associated with the US of nursing care breakdown, urinary medication administration per and RN tract infection, blood errors (0.39; No p=0.006). skill mix stream infection, & other significant central catheter associations. No significant infection relationships with skill mix. Kim et al., 2012 Adult patients No intervention - No specific Mortality from Prospective Hospitals with a 1:2 ratio In-hospital mortality 3e (n=251) in 28 used comparator sepsis observational had significantly lower from sepsis adult ICUs in ratios study hospital, ICU and 28-day Korea mortality than those with a 1:3 or 1:4 or more Lake et al., 2010 1293 ICUs in a No intervention - No specific Inpatient falls Retrospective An additional RN hour per Fall rate 3e sample of 5,388 used nursing care comparator cross-sectional patient day was associated nursing units in per patient study with a 3% lower fall rate in 636 hospitals in day ICUs the US
Kelly, 2012 Adult patients (n=56,826) who were mechanically ventilated in ICUs in 303 hospitals in the US No intervention - used mean patients per nurse No specific comparator 30-day mortality, ICU and hospital LOS, ventilator associated pneumonia, central line associated bloodstream infection Retrospective cross sectional No significant relationship between staffing and mortality, hospital LOS, central line infection or ventilator associated pneumonia - Significant association between staffing and ICU LOS ICU LOS 3e & Blegen, 2009 Adult patients from 48 ICUs in 29 hospitals in the US No specific intervention: Used total hours of nursing care per day and RN skill mix No specific comparator Medication administration errors, falls, skin breakdown, urinary tract infection, blood stream infection, & central catheter infection Cross sectional Total hours of nursing care per patient day was positively associated with medication administration errors (0.39; p=0.006). No other significant associations. No significant relationships with skill mix. Medication administration errors 4b Kim et al., 2012 Adult patients (n=251) in 28 adult ICUs in Korea No intervention - used ratios No specific comparator Mortality from sepsis Prospective observational study Hospitals with a 1:2 ratio had significantly lower hospital, ICU and 28-day mortality than those with a 1:3 or 1:4 or more In-hospital mortality from sepsis 3e Lake et al., 2010 1293 ICUs in a sample of 5,388 nursing units in 636 hospitals in the US No intervention - used nursing care per patient day No specific comparator Inpatient falls Retrospective cross-sectional study An additional RN hour per patient day was associated with a 3% lower fall rate in ICUs Fall rate 3e