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The influence of delayed admission to intensive care unit on mortality and nursing workload: a cohort study.
Nurs Crit Care. 2018 Nov 26;:
Authors: Oliveira EG, Garcia PC, Citolino Filho CM, Nogueira LS
Abstract
BACKGROUND: The results of studies regarding the relationship between length of stay of patients in emergency departments (EDs) and mortality in intensive care units (ICUs) are contradictory, and nothing is known about the impact of delayed admission of patients to ICUs on nursing workload.
AIMS AND OBJECTIVES: To assess the influence of the time lapse between ED and ICU admissions on mortality and nursing workload in relation to intensive care patients.
DESIGN: This was a retrospective cohort study that examined the medical records of patients who were 15 years of age or older and admitted directly to the ICU from the ED.
METHODS: The data were collected between 2014 and 2016 in a hospital located in São Paulo, Brazil. Nursing workload was measured by the Nursing Activities Score. Multiple linear and logistic regressions were applied, with a significance level of 5%.
RESULTS: Of the 534 patients analysed, the majority were men (57·49%); the mean age was 55·37 ± 19·64 years. Length of stay in the ED was not associated with nursing workload at the time of admission of patients to the ICU or during their stay in the unit. For mortality, this variable was a risk factor along with cause of admission, length of stay in the ICU and the Simplified Acute Physiology Score 3 score. For every additional hour that patients remained in the ED, their chance of dying in the ICU increased by 1%.
CONCLUSION: Length of stay of patients in the ED was a risk factor for mortality in the ICU; however, this variable did not have any influence on nursing workload.
RELEVANCE TO CLINICAL PRACTICE: Strategies need to be implemented to optimize the availability of ICU beds and reduce the length of stay of critical patients in the ED as delays in admitting such patients to the ICU have an impact on mortality.
PMID: 30478867 [PubMed - as supplied by publisher]