ArticleAnnals of intensive care2020
The effect of bed-to-nurse ratio on hospital mortality of critically ill children on mechanical ventilation: a nationwide population-based study.
Article in Annals of intensive care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 42 citations in OpenAlex.
- Trial
- Delayed at the Door: Impact of Pandemic Response Policies on Emergency and Critical Care in Korea: An Interrupted Time-Series Analysis.Journal of Korean medical science · 2026Article
- Development and validation of novel simple prognostic model for predicting mortality in Korean intensive care units using national insurance claims data.The Korean journal of internal medicine · 2024Article
- Impact of the early phase of the COVID-19 pandemic on emergency department-to-intensive care unit admissions in Korea: an interrupted time-series analysis.BMC emergency medicine · 2024Article
- Association between intensive care unit nursing grade and mortality in patients with cardiogenic shock and its cost-effectiveness.Critical care (London, England) · 2024Article
- Article
- Effect of high-flow nasal cannula therapy on mechanical ventilation duration in the pediatric intensive care unit.PloS one · 2024Article
- Optimizing Pharmacist Team-Integration for ICU Patient Management: Rationale, Study Design, and Methods for a Multicentered Exploration of Pharmacist-to-Patient Ratio.Critical care explorations · 2023Article
- Incidence and Mortality Trends in Critically Ill Children: A Korean Population-Based Study.Journal of Korean medical science · 2023Article
- Article
- The positive impact of COVID-19 on critical care: from unprecedented challenges to transformative changes, from the perspective of young intensivists.Annals of intensive care · 2023Review
- Is nurse staffing associated with critical deterioration events on acute and critical care pediatric wards? A literature review.European journal of pediatrics · 2023Review
- Trends in Incidences and Survival Rates in Pediatric In-Hospital Cardiopulmonary Resuscitation: A Korean Population-Based Study.Journal of the American Heart Association · 2023Article
- Association between ondansetron use and mortality of patients on mechanical ventilation in the intensive care unit: a retrospective cohort study.Annals of translational medicine · 2023Article
- Mechanical ventilation in snake envenomation of dogs and cats.Frontiers in veterinary science · 2023Review
- Article
- Multiple Layers of Care and Risk: Comparing Cross-Specialty Outcomes Using Regional, Hospital, and Patient-Level Data.JACC. Advances · 2022Article
- Medication regimen complexity vs patient acuity for predicting critical care pharmacist interventions.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2022Observational
- Rehabilitation in critically ill children: Findings from the Korean National Health Insurance database.PloS one · 2022Article
- Health disparities of critically ill children according to poverty: the Korean population-based retrospective cohort study.BMC public health · 2021Article
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite the high workload of mechanical ventilation, there has been a lack of studies on the association between nurse workforce and mortality in mechanically ventilated patients. We evaluated the association of the bed-to-nurse ratio with mortality in ventilated pediatric patients admitted to an intensive care unit (ICU).
methodsWe conducted a nationwide retrospective analysis by using the Korean National Health Insurance database, which categorizes the bed-to-nurse ratio into 9 grades according to the number of beds divided by the number of full-time equivalent registered nurses in a unit. Patients of ages between 28 days and 18 years were enrolled. Multiple admissions and transfers from other hospitals were excluded. We evaluated the odds ratios (ORs) of in-hospital mortality using 4 groups (Grade 1: bed-to-nurse < 0.50, Grade 2: < 0.63, Grade 3: < 0.77, Grade 4 or above > 0.77) with adjustment of patient factors, hospital factors, and treatment requirements.
resultsOf the 27,849 patients admitted to ICU, 11,628 (41.8%) were on mechanical ventilation. The overall in-hospital mortality rates in Grade 1, Grade 2, Grade 3, and Grade 4 or above group were 4.5%, 6.8%, 6.9%, and 4.7%, respectively. The adjusted ORs (95% CI) for in-hospital mortality of mechanically ventilated patients in the Grade 2, Grade 3, and Grade 4 or above compared to those in Grade 1 were 2.73 (95% CI 1.51-4.95), 4.02 (95% CI 2.23-7.26), and 7.83 (4.07-15.07), respectively. However, for patients without mechanical ventilation, the adjusted ORs of in-hospital mortality were not statistically significant.
conclusionIn mechanically ventilated patients, the adjusted mortality rate increased significantly, as the bed-to-nurse ratio of the ICU increased. Policies that limit the number of ventilated patients per nurse should be considered. Trial registration retrospectively registered.
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