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

Current Status of Intensive Care Units Registered as Critical Care Subspecialty Training Hospitals in Korea

“…Only 7.7% of adult ICUs were staffed by physician specialists for 5 days each week. The outcome of severe sepsis and compliance with the Surviving Sepsis Campaign in Korea was poor in ICUs without fulltime intensivists (1). In several studies that evaluated the association between ICU physician staffing and patient outcomes, higher staffing of intensivists was associated with lower hospital mortality and morbidity (13-17).…”

“…Compared with other medical fields, the quality of critical care has lagged behind that of advanced countries. Moreover, the level of critical care quality differs significantly between university hospital ICUs (1). …”

Outcomes and prognostic factors in patients with prolonged acute mechanical ventilation: A single-center study in Korea

“…In addition to these variables, clinical outcomes in these patients would be influenced by other factors such as the opinions of the patients' family and physician-family communications. Moreover, in Asian ICUs (including in Korea), critical care resources and facilities of university hospitals are typically limited compared to those of other developed countries in North America and Europe [21,22]. In addition, a shortage of critical care personnel including full-time intensivists and a low nurse-topatient ratio exists, which is a serious issue for clinical practice.…”

Infrastructure and Organization of Adult Intensive Care Units in Resource-Limited Settings

“…More nurses available per ICU bed improves survival rates, particularly for patients at a high risk of dying [11], reduces postoperative [12] and infectious complications like ventilator-associated pneumonia [13], and prevents medication errors [14]. A higher nurse-to-patient ratio is also independently associated with a better compliance with, for example, sepsis care bundles [15]. Notably, a higher nurse-to-patient ratio prevents burnout of nurses [16].…”