Table 1.
Primary outcome: Insufficient ICU skill-mix | All days | No | Yes | P value |
---|---|---|---|---|
Days with more patients needing 1:1 nursing than CCRNs, % (number) | - | 89.7% (2445/2725) | 10.3% (280/2725) | N/A |
Secondary outcome: Insufficient ventilated skill-mix | 0.7% (19/2725) | 0% (0/2445) | 6.8% (19/280) | N/A |
Secondary outcome: Reduced ICU nursing ratio | 3% (82/2725) | 1.8% (43/2445) | 13.9% (39/280) | <0.001 |
Mean daily CCRNs per site | 8 (5-17) [1, 70] | 8 (5-17) [2, 70] | 8 (4-23) [1, 58] | 0.33 |
Group 1 (CCRN nurses - experienced) | 7 (4-13) [1, 48] | 7 (4-13) [1, 48] | 6 (3-19) [1, 43] | 0.98 |
Group 2 (CCRN nurses - early career) | 2 (1-4) [0, 33] | 2 (1-4) [0, 33] | 2 (1-5) [0, 30] | 0.62 |
Mean daily non-CCRNs per site | 1 (0-2) [0, 31] | 0 (0-2) [0, 20] | 4 (2-7) [0, 31] | <0.001 |
Group 3 (non-CCRN redeployed nurses) | 0 (0-2) [0, 31] | 0 (0-2) [0, 20] | 4 (2-7) [0, 31] | <0.001 |
Group 4 (RUSONs, enrolled nurses & allied health) | 0 (0-0) [0, 4] | 0 (0-0) [0, 4] | 0 (0-0) [0, 2] | <0.001 |
Critical care staff unavailable due to COVID-19 illness or furlough | 1.6 (0-4) [0, 131.8] | 1.5 (0-4) [0, 131.8] | 2 (0-5) [0, 61] | 0.63 |
Open available ICU beds | 8 (5.5-15.5) [0, 65.3] | 8 (5.5-15) [0, 63.8] | 11.8 (5-27.2) [4, 65.3] | 0.001 |
ICU beds open over 'business as usual' | -2 (-4-0.3) [-23, 19.3] | -2 (-4-0) [-23, 17.8] | 1 (-2-2.6) [-18, 19.3] | <0.001 |
Vacant ICU beds | 1.8 (0.8-3) [0, 12.7] | 2 (1-3) [0.1, 12.7] | 1 (0.2-1.8) [0, 8.3] | <0.001 |
ICU occupancy | 83% (64-93.5) [0, 200] | 81% (60-92) [0, 200] | 96% (88.6-100) [66.7, 150] | <0.001 |
Activity Index | 1.1 (0.6-1.5) [0, 2.8] | 1 (0.5-1.5) [0, 2.8] | 1.6 (1.2-1.9) [0.7, 2.6] | <0.001 |
Days with Activity Index > 2.0, % (number) | 6.5% (178/2725) | 5.1% (125/2445) | 18.9% (53/280) | <0.001 |
'ICU equivalent' patients | 6.5 (3.5-14) [0, 63.8] | 6 (3.3-13.3) [0, 62] | 10.8 (5-26) [2.7, 63.8] | <0.001 |
Patients in ICU needing 1:1 critical care nursing | 5 (2-13.3) [0, 62.3] | 4.5 (1.5-12.8) [0, 60] | 9.8 (5-24.8) [2.5, 62.3] | <0.001 |
Ventilated patients | 2.5 (0.7-7) [0, 46.7] | 2 (0.5-6.5) [0, 43.8] | 6 (2-16.2) [0, 46.7] | <0.001 |
COVID-19 patients in each ICU | 1 (0-3) [0, 32.3] | 0.5 (0-2) [0, 31] | 3 (1-9) [0, 32.3] | <0.001 |
HDU patients (1:2 nursing) in each ICU | 2.3 (0.7-4.3) [0, 14] | 2.5 (1-4.5) [0, 14] | 0 (0-2) [0, 12] | <0.001 |
COVID-19 patients on the hospital ward | 6 (0-16.8) [0, 173] | 6 (0-16) [0, 173] | 10.1 (0-23) [0, 119.5] | 0.10 |
Data reported are median (interquartile range) [minimum, maximum] daily values per site (unless otherwise stated).
CCRN, critical care registered nurse; COVID-19, coronavirus disease 2019; HDU, high-dependency unit; ICU, intensive care unit; RUSON, Registered undergraduate student of nursing.