PROBLEMS ASSOCIATED WITH NURSING STAFF SHORTAGE - AN ANALYSIS OF THE FIRST 3600 INCIDENT REPORTS SUBMITTED TO THE AUSTRALIAN INCIDENT MONITORING STUDY (AIMS-ICU)

Although many studies have attempted to define appropriate nursing sta ff levels, allocation and patient dependency, minimal data is availabl e on the effect of nursing staff shorting (NSS) on quality of care pro vided in intensive care. This study aimed to identify incidents associ ated with staff shortage as reported to the Australian Incident Monito ring Study-ICU (AIMS-ICU) project and to assess their estimated effect on patient outcome. A search of narrative keywords and contributing f actors identified 89 nursing staff shortage incidents (NSS-INCIDENTS) and 373 incidents involving nursing staff shortage contributing factor s (NSS-CF). NSS resulting from inappropriate rostering for current pat ient load (81%) and inability to respond to increased unit activity (1 9%). Most frequent associated incidents included problems with: drug a dministration/documentation (47), patient supervision (20), set-up of ventilators/equipment (16), and accidental extubation (14). Undesirabl e patient outcomes included: major physiological change (22%), patient /relative dissatisfaction (12%), and physical injury (3%). This study suggests that inadequate staffing results in incidents and compromised patient safety.