Current trends of clinical and genetic characteristics influencing the resource use and the nurse-patient balance in an intensive care setting.
OBJECTIVE
To determine the impact of resource use on the nurse/patient ratio in a pediatric intensive care unit (PICU). To examine the longitudinal influence of chronic or genetically influenced diseases on this interrelation.


METHODS
Overall, 1586 patients admitted to the PICU through various modes of admission during a 5-year period were prospectively studied.


RESULTS
The mean daily number of bed use increased from 5 to 8.1, leading to a significant skew from the ideal nurse/patient ratio of 1:1, to an overloaded one of 1:3-5. An increasing longitudinal trend of patients with metabolic diseases (P < .0001) or with genetic influence (62.8% in 1997, 70.7% in 2001) was noted. More patients with a genetic influence died than those without (13.8% vs 8.5%, P < .001), and more patients supported by mechanical ventilation suffered from a genetically influenced disease (64% vs 36%, P < .03). The mortality rate showed a trend for longitudinal reduction from 12.6% to 12%.


CONCLUSIONS
The increasing trend of occupation of PICU bed and ventilator days by patients with chronic diseases may be related to the increasing trend of hospitalization of patients with recognized genetic influence. Although this new trend does not influence mortality, it significantly increases resource use and has a large impact on the staffing needs.
Briassoulis
George
G
Pediatric Intensive Care Unit, Aghia Sophia Children's Hospital, Goudi, Athens, Greece. briassg@otenet.gr
Filippou
Olga
O
Mavrikiou
Maria
M
Natsi
Labrini
L
Ktistaki
Maria
M
Hatzis
Tassos
T
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D030342:Genetic Diseases, Inborn / Q000451:nursing; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D007902:Length of Stay; D008137:Longitudinal Studies; D009732:Nursing Care / Q000706:statistics & numerical data*; D011446:Prospective Studies