title: The effect of continuity in nursing care on patient outcomes in the pediatric intensive care unit.
abstract: BACKGROUND
  Previous studies have examined the links between continuity of care and patient outcomes, but little is known about this relationship in acute care pediatric settings.
  
  
  OBJECTIVE
  The aim of this study was to examine the associations between continuity in nursing care (CINC), defined as fewer nurses caring for a patient, and patient outcomes in a pediatric intensive care unit (ICU).
  
  
  METHODS
  A secondary analysis of prospectively collected data was carried out.
  
  
  RESULTS
  A total of 332 patients admitted to the medical/surgical ICU at Children's Hospital Boston from March 2004 to December 2012 were included in the study. The mean (SD) Continuity of Care Index score was 0.4 (0.1). Multivariable analyses demonstrated that CINC was associated with a longer ICU stay (P < .001) and longer ventilator days (P = .01) but was not associated with the occurrence of adverse events and ICU-acquired infections. When a match between nurse expertise and mortality risk was included as interaction term, CINC was significantly associated with fewer nurse-sensitive adverse events (P = .05).
  
  
  CONCLUSIONS
  In this study, sicker patients were more likely to receive more CINC. Continuity in providers may have the potential to affect patient outcomes. More studies are needed to explore this relationship.
authors.affiliation: Academic Programs Division, Singapore Institute of Technology, Singapore. Elaine.Siow@SingaporeTech.edu.sg
authors.forename: Elaine
authors.initials: E
authors.lastname: Siow
authors.forename: David
authors.initials: D
authors.lastname: Wypij
authors.forename: Patricia
authors.initials: P
authors.lastname: Berry
authors.forename: Patricia
authors.initials: P
authors.lastname: Hickey
authors.forename: Martha A Q
authors.initials: MA
authors.lastname: Curley
mesh_terms: D001900:Boston; D002648:Child; D002675:Child, Preschool; D003266:Continuity of Patient Care; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay; D008297:Male; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D018802:Patient-Centered Care / Q000592:standards; D010561:Personnel Staffing and Scheduling; D016016:Proportional Hazards Models; D011446:Prospective Studies; D000078329:Workforce