Nurse-to-Nurse Familiarity and Mortality in the Critically Ill. A Multicenter Observational Study - Inserm - Institut national de la santé et de la recherche médicale Access content directly
Journal Articles American Journal of Respiratory and Critical Care Medicine Year : 2022

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

Abstract

RATIONALE: Nurse-to-nurse familiarity at work should strengthen the components of team working and enhance its efficiency. However, its impact on patient outcomes in critical care remains poorly investigated. OBJECTIVES: To explore the role of nurse-to-nurse familiarity on inpatient deaths during intensive care unit stay. METHODS: Retrospective observational study in eight adult academic intensive care units between 01/01/2011 and 31/12/2016. MEASUREMENTS AND MAIN RESULTS: Nurse-to-nurse familiarity was measured across day and night 12-hour daily shifts as the mean number of previous collaborations between each nursing team member during previous shifts within the given Intensive Care Unit (suboptimal if\textless50). Primary outcome was a shift with at least one inpatient death, excluding death of patients with a decision to forego life-sustaining therapy. A multiple modified Poisson regression was computed to identify the determinants of mortality per shift, taking into account intensive care unit, patients' characteristics, patient-to-nurse and patient-to-assistant nurse ratios, nurse experience length and workload. A total of 43,479 patients were admitted of whom 3,311 (8%) died. Adjusted model showed a lower risk of a shift with mortality when nurse-to-nurse familiarity increased in the shift (relative risk 0.90 [0.82-0.98] 95%confidence intervals per 10 shifts, p=0.012). Low nurse-to-nurse familiarity during the shift combined with suboptimal patient-to-nurse and assistant-nurse ratios (suboptimal if \textgreater2.5 and \textgreater4, respectively) were associated with increased risk of shift with mortality (1.84 [1.15-2.96], p\textless0.001). CONCLUSIONS: Shifts with low nurse-to-nurse familiarity were associated with an increased risk of patient deaths.
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Dates and versions

inserm-03987314 , version 1 (14-02-2023)

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A. Duclos, C. Payet, L. Baboi, B. Allaouchiche, L. Argaud, et al.. Nurse-to-Nurse Familiarity and Mortality in the Critically Ill. A Multicenter Observational Study. American Journal of Respiratory and Critical Care Medicine, 2022, Online ahead of print. ⟨10.1164/rccm.202204-0696OC⟩. ⟨inserm-03987314⟩
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