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Influence of full-time intensivist and the nurse-to-patient ratio on the implementation of severe sepsis bundles in Korean intensive care units.

 Je Hyeong Kim  ;  Suk-Kyung Hong  ;  Kyung Chan Kim  ;  Myung-Goo Lee  ;  Ki Man Lee  ;  Sung Soo Jung  ;  Hye Sook Choi  ;  Jin Hwa Lee  ;  Ki-Suk Jung  ;  Sung-Soon Lee  ;  Jae Hwa Cho  ;  Shin Ok Koh  ;  Moo Suk Park  ;  Kwang Won Seo  ;  Younsuck Koh 
 JOURNAL OF CRITICAL CARE, Vol.27(4) : 414-21, 2012 
Journal Title
Issue Date
Aged ; Clinical Protocols ; Female ; Humans ; Intensive Care Units/organization & administration* ; Intensive Care Units/statistics & numerical data ; Male ; Medicine/statistics & numerical data* ; Middle Aged ; Nursing Staff, Hospital/organization & administration* ; Nursing Staff, Hospital/statistics & numerical data ; Outcome Assessment (Health Care) ; Personnel Staffing and Scheduling/organization & administration ; Personnel Staffing and Scheduling/statistics & numerical data ; Republic of Korea ; Sepsis/mortality* ; Sepsis/therapy*
Sepsis Intensive care units Sepsis resuscitation bundle ; Sepsis management bundle ; Compliance ; Critical care personnel
PURPOSE: The reported actual compliance for severe sepsis bundles was very low, suggesting the presence of barriers to their implementation. The purpose of this study was to assess the influence of full-time intensivist and nurse-to-patient ratio in Korean intensive care units (ICUs) on the implementation of the severe sepsis bundles and clinical outcome. MATERIALS AND METHODS: A total of 251 patients with severe sepsis were enrolled from 28 adult ICUs during the July, 2009. We recorded the organizational characteristics of ICUs, patients' characteristics and clinical outcomes, and the compliance for severe sepsis bundles. RESULTS: Complete compliance with the resuscitation bundle and totally complete compliance with all element targets for resuscitation and management bundles were significantly higher in the ICU with full-time intensivist and a nurse-to-patient ratio of 1:2 (P < .05). The hazard ratio (HR) for hospital mortality was independently reduced by the presence of full-time intensivist (HR, 0.456; 95% confidence interval, 0.223-0.932), and a nurse-to-patient ratio of 1:2 was independently associated with a lower 28-day mortality (HR, 0.459; 95% confidence interval, 0.211-0.998). CONCLUSIONS: The full-time intensivist and the nurse-to-patient ratio had a substantial influence on the implementation of severe sepsis bundles and the mortalities of patients with severe sepsis.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Koh, Shin Ok(고신옥)
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
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