title: Current trends of clinical and genetic characteristics influencing the resource use and the nurse-patient balance in an intensive care setting.
abstract: 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.
authors.affiliation: Pediatric Intensive Care Unit, Aghia Sophia Children's Hospital, Goudi, Athens, Greece. briassg@otenet.gr
authors.forename: George
authors.initials: G
authors.lastname: Briassoulis
authors.forename: Olga
authors.initials: O
authors.lastname: Filippou
authors.forename: Maria
authors.initials: M
authors.lastname: Mavrikiou
authors.forename: Labrini
authors.initials: L
authors.lastname: Natsi
authors.forename: Maria
authors.initials: M
authors.lastname: Ktistaki
authors.forename: Tassos
authors.initials: T
authors.lastname: Hatzis
mesh_terms: 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