Objective: The purpose of this study was to examine the association between intensive care unit nurse (ICU) staffing and the likelihood of complications for patients undergoing abdominal aortic surgery.
Design: The study is a retrospective review of hospital discharge data linked to data on ICU organizational characteristics.
Setting: Research took place in ICUs in non-federal, short-stay hospitals in Maryland.
Patients: Study included 2606 patients undergoing abdominal aortic surgery in Maryland between January 1994 and December 1996.
Outcome Measures: Outcome measures included cardiac, respiratory, and other complications.
Results: Cardiac complications occurred in 13% of patients, respiratory complications occurred in 30%, and other complications occurred in 8% of patients. Multiple logistic regression revealed a statistically significant increased likelihood of respiratory complications (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.50-3.60) in abdominal aortic surgery patients cared for in ICUs with low- versus high-intensity nurse staffing, an increased likelihood of cardiac complications (OR, 1.78; CI, 1.16-2.72) and other complications (OR, 1.74; CI, 1.15-2.63) in ICUs with medium- versus high-intensity nurse staffing, after controlling for patient and organizational characteristics.
Conclusions: Within the range of ICU nurse staffing levels present in Maryland hospitals, decreased nurse staffing was significantly associated with an increased risk of complications in patients undergoing abdominal aortic surgery.
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