성인중환자실 이용 환자의 사망률 관련 요인 분석: 간호등급을 중심으로

Abstract

Purpose: The purpose of this study was to assess the influence of nurses staffing level on patient health outcomes inintensive care units (ICUs) in Korea. Methods: The study was retrospective in nature. Information on patients and theiroutcomes, as well as nurse cohort data, were obtained from Korea's National Health Insurance Service Database. Theobservation period was from January 1, 2008 to December 31, 2018, and data for 2,964,991 patients were analyzed. Independent variables included patient' age and sex and hospital type, intensivist, and nurses staffing level. Results: Themortality rate in ICUs was significantly higher at tertiary hospitals with a level 3~4 (HR, 1.21; 95% confidence interval,1.19~1.22) or level 5~9 nurse staffing (HR, 1.31; 95% confidence interval, 1.27~1.34) compare to that of tertiary hospitalswith a 1~2 level. 28-day mortality rate was also higher at general hospitals with a level 3~4 (HR, 1.13; 95% confidenceinterval, 1.12~1.14), level 5~6 (HR. 1.34; 95% confidence interval, 1.32~1.36), level 7~9 nurse staffing (HR, 1.38; 95%confidence interval, 1.38~1.42), using level 1~2 as reference. Conclusion: Nurses staffing level is a key determinant ofhealthcare-associated mortality in critically ICUs patients. Policies to achieve adequate nurse staffing levels are thereforerequired to enhance patient outcomes