derangements, relationships found. respiratory failure, Higher non-RN HPPD pulmonary related to lower O/E ratios embolism, DVT of PE and DVT Pronovost et al., Adult patients Nurse-to-patient Nurse-to-patient Pulmonary Observational Nurse patient ratios of 1:3 Any complication, 3e 2001 (n=2,606) ratio during day ratio categorised insufficiency, study or 1:4 were associated any medical aortic and evening as: 1:1 or 1:2 = tracheal with increased risk for any complication, surgery in ICUs in "More ICU reintubation, cardiac complication; RR 1.7 (1.3 pulmonary 38 Maryland nurses"; ratios of complications a to 2.4), any medical insufficiency after hospitals 1:3 or 1:4 = acute complication; RR 4.5 (1.5 procedure, and "fewer ICU renal failure, to 2.9), pulmonary reintubation nurses" septicaemia, acute insufficiency after myocardial procedure; RR 4.5 infarction, cardiac and reintubation; RR arrest, surgical 1.6 (1.1 to 2.5). All other complications after a outcomes non-significant. procedure, puncture, perforation or haemorrhage during surgery, reoperation for bleeding Robert et al., Adult patients in a No intervention - No specific Nosocomial Case-control Significant relationship BSI 3d 2000 surgical ICU in looked at comparator bloodstream study between BSI and lower one hospital in ratio in 3 infections nurse to patient ratios and the US - 28 days prior to higher pool nurse to patients with BSI index date as the patient ratios and 99 controls exposure variable
derangements, respiratory failure, pulmonary embolism, DVT relationships found. Higher non-RN HPPD related to lower O/E ratios of PE and DVT Pronovost et al., 2001 Adult patients (n=2,606) aortic surgery in ICUs in 38 Maryland hospitals Nurse-to-patient ratio during day and evening Nurse-to-patient ratio categorised as: 1:1 or 1:2 = "More ICU nurses"; ratios of 1:3 or 1:4 = "fewer ICU nurses" Pulmonary insufficiency, tracheal reintubation, cardiac complications a acute renal failure, septicaemia, acute myocardial infarction, cardiac arrest, surgical complications after a procedure, puncture, perforation or haemorrhage during surgery, reoperation for bleeding Observational study Nurse patient ratios of 1:3 or 1:4 were associated with increased risk for any complication; RR 1.7 (1.3 to 2.4), any medical complication; RR 4.5 (1.5 to 2.9), pulmonary insufficiency after procedure; RR 4.5 and reintubation; RR 1.6 (1.1 to 2.5). All other outcomes non-significant. Any complication, any medical complication, pulmonary insufficiency after procedure, and reintubation 3e Robert et al., 2000 Adult patients in a surgical ICU in one hospital in the US - 28 patients with BSI and 99 controls No intervention - looked at ratio in 3 days prior to index date as the exposure variable No specific comparator Nosocomial bloodstream infections Case-control study Significant relationship between BSI and lower nurse to patient ratios and higher pool nurse to patient ratios BSI 3d
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