AIM To investigate the effect of nurse staffing on infection and mortality rate during intensive care unit (ICU) stay, by considering patient care demands. MATERIAL-METHOD This was a prospective study conducted in the general ICU of General University Hospital of Patras. All patients consecutively admitted during an 1-year period were enrolled. APACHE II and TISS-28 scores were used for the evaluation of clinical severity and daily care demands of patients respectively. On a daily basis, the sum of TISS-28 scores and the number of nurses employed were considered for the estimation of median and peak patient exposure to nursing workload. Logistic regression was used for statistical analysis of data. RESULTS Three hundred ninety-six patients were included. ICU-acquired infection was documented in 97 patients, while 102 of them died during ICU stay. Between the low and the high workload group, ICU-acquired infection rate increased by 59% and 53% according to the median and peak patient exposure to nursing workload respectively. Similarly, ICU mortality rate increased by 36% and 51% according to the median and peak patient exposure to nursing workload respectively. Remarkable increases of both rates were also detected when medical and surgical patients were separately studied. CONCLUSIONS These findings support the effect of nursing workload on ICU-acquired infections and ICU mortality of patients and highlight the importance of evaluating individual patient care demands.
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