Abstract
The increasing incidence of ischemic heart disease is concomitantly increasing percutaneous coronary intervention (PCI) treatments. Adequate nurse staffing has enhanced quality of care and this study was conducted to determine the relationship between survival-related PCI treatment and the level of nursing staff who care for patients admitted to receive PCI. National Health Insurance claims data from 2014 to 2015 for 67,927 patients who underwent PCI in 43 tertiary hospitals were analyzed. The relationships of nurse staffing in intensive care units (ICUs) and general wards with survival after PCI were investigated using logistic regression analyses with a generalized estimation model. The in-hospital mortality rate in ICUs was lower in hospitals with first-grade nurse staffing {odds ratio (OR) = 0.33, 95% confidence interval (CI) = 0.23–0.48}, second-grade nurse staffing (OR = 0.55, 95% CI = 0.40–0.77), or third-grade nurse staffing (OR = 0.71, 95% CI = 0.53–0.95) than in hospitals with fifth-grade nurse staffing. Nurse staffing in general wards was not related to in-hospital mortality due to PCI treatment. This study found that nurse staffing in PCI patients requiring short-term intensive care significantly affected patient survival. An understanding of the importance of managing the ICU nursing workforce for PCI treatment is required.
Highlights
The incidence of ischemic heart disease has been increasing in Korea and medical services were used by 867,540 Korean patients in 2012, which increased to 965,448 in 2016 [1]
There were 40 (93.0%) hospitals that had a physician in charge of the intensive care units (ICUs), and the survival rate after the percutaneous coronary intervention (PCI) procedures was not significantly affected by whether or not the hospital had a physician in charge of the ICU
There were first, second, third, and fifth grade nurses in the ICUs in the data analyzed in this study, and it was confirmed that in-hospital mortality was significantly low when nursing staff were better than fifth grade
Summary
The incidence of ischemic heart disease has been increasing in Korea and medical services were used by 867,540 Korean patients in 2012, which increased to 965,448 in 2016 [1]. Medical expenses have been increasing in Korea in recent years and the medical expense per patient with ischemic heart disease was 6,550,303 KRW (Korean won) in 2012, which increased to 7,291,188. The in-hospital mortality rate in patients with AMI treated with percutaneous coronary intervention (PCI) in Korea was 3.8% in. Increasing the survival probability after ischemic heart disease is very important. Studies in other countries have investigated nurse staffing as an influence on PCI outcomes [7]. Nurses participate in the PCI procedure as a member of the expert group [7] and play an important role in providing
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