Ratio of ICU Nurses to Patients Affects Outcomes

A study has demonstrated that intensive care units (ICUs) having ratios of one nurse for every three or four patients, rather than one or two, have significantly higher rates of post-surgical complications. Conducted by researchers at Johns Hopkins Medical Institutions (Baltimore, MD, USA), the study was published in the October 2001 issue of Effective Clinical Practice.

In the study, the researchers analyzed hospital discharge data for 2,606 abdominal aneurysm patients treated at 38 hospitals between 1994 and 1996, reviewing medical and surgical complications and surveying medical and nursing directors about staffing, including the nurse-to-patient ratio. Seven hospitals with a total of 478 patients had a lower ratio of ICU nurses per patient, while 31 hospitals with a total of 2,128 patients had a higher ratio. Patients treated in the hospitals with a lower nurse-to-patient ratio were more likely to have medical complications (43% vs. 28%), respiratory failure (21% vs. 13%), or need a breathing tube re-inserted (21% vs. 13%). Nurse staffing did not affect the risk for surgical complications.

"Hospital administrators who reduce the number of ICU nurses in order to cut costs may actually increase costs in the long run,” said Dr. Peter J. Pronovost, associate professor of anesthesiology and critical care medicine at Johns Hopkins and lead author of the study.




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