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The influence of delayed admission to intensive care unit on mortality and nursing workload: a cohort study
Author(s) -
Oliveira Ester Góes,
Garcia Paulo Carlos,
Citolino Filho Clairton Marcos,
Nogueira Lilia
Publication year - 2019
Publication title -
nursing in critical care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.689
H-Index - 43
eISSN - 1478-5153
pISSN - 1362-1017
DOI - 10.1111/nicc.12402
Subject(s) - medicine , workload , intensive care unit , logistic regression , retrospective cohort study , intensive care , emergency medicine , cohort , cohort study , intensive care medicine , computer science , operating system
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.