Nurse-to-Nurse Familiarity and Mortality in the Critically Ill: A Multicenter Observational Study

• DOI: 10.1164/rccm.202204-0696oc
• Publication Date: 2022-10-11T15:53:33Z
• Authors: Antoine Duclos; Cécile Payet; Loredana Baboi; Bernard Allaouchiche; Laurent Argaud; Frédéric Aubrun; Julien Bohé; Frédéric Dailler; Jean-Luc Fellahi; Jean-Jacques Lehot; Vincent Piriou; Thomas Rimmelé; Delphine Terragrossa; Stéphanie Polazzi; Claude Guérin
• Keywords: Adult; Critical Illness; Personnel Staffing and Scheduling; 610; Workload; 3. Good health; [SDV.AEN] Life Sciences [q-bio]/Food and Nutrition; Intensive Care Units; 03 medical and health sciences; 0302 clinical medicine; Staffing; Humans; Working familiarity; Nurse-to-nurse familiarity; Hospital Mortality; Intensive Care Unit Organization; [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition; Outcome

Rationale: Nurse-to-nurse familiarity at work should strengthen the components of teamwork and enhance its efficiency. However, impact on patient outcomes in critical care remains poorly investigated. Objectives: To explore role nurse-to-nurse inpatient deaths during ICU stay. Methods: This was a retrospective observational study eight adult academic ICUs between January 1, 2011 December 31, 2016. Measurements Main Results: measured across day night 12-hour daily shifts as mean number previous collaborations each nursing team member within given (suboptimal if <50). Primary outcome shift with least one death, excluding death patients decision to forego life-sustaining therapy. A multiple modified Poisson regression computed identify determinants mortality per shift, taking into account ICU, characteristics, patient-to-nurse patient-to-assistant nurse ratios, experience length, workload. total 43,479 were admitted, whom 3,311 (8%) died. The adjusted model showed lower risk when increased (relative risk, 0.90; 95% confidence interval 10 shifts, 0.82-0.98; P = 0.012). Low combined suboptimal ratios >2.5 >4, respectively) associated 1.84; interval, 1.15-2.96; < 0.001). Conclusions: Shifts low an deaths.