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. 2022 Dec 12;36(1):84–91. doi: 10.1016/j.aucc.2022.12.001

Table 1.

Staffing and activity characteristics of ICUs on days with and without insufficient ICU skill-mix (more patients needing 1:1 critical care nursing than available CCRNs: primary study outcome).

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.