Workforce and Task Sharing of Nurses in the Japanese Intensive Care Unit-Cross-Sectional Postal Survey

Abstract

This study aimed to estimate the number of nurses who independently care for patients with severe respiratory failure receiving mechanical ventilation (MV) or veno-venous extracorporeal membrane oxygenation (VV-ECMO). Additionally, the study analyzed the actual role of nurses in the treatment of patients with MV and VV-ECMO. We performed a cross-sectional study using postal questionnaire surveys. The study included 725 Japanese intensive care units (ICUs). Data were analyzed using descriptive statistics. Among the 725 ICUs, we obtained 302 responses (41.7%) and analyzed 282 responses. The median number of nurses per bed was 3.25. The median proportion of nurses who independently cared for patients with MV was 60% (IQR: 42.3–77.3). The median proportion of nurses who independently cared for patients with VV-ECMO was 46.9 (35.7–63.3%) in the ICUs that had experience with VV-ECMO use. With regard to task-sharing, 33.8% of ICUs and nurses did not facilitate weaning from MV. Nurses always titrated sedative dosage in 44.5% of ICUs. Nurse staffing might be inadequate in all ICUs, especially for the management of patients with severe respiratory failure. The proportion of competent nurses to care for severe respiratory failure in ICUs should be considered when determining the workforce of nurses.

Clinical practice competencies for standard critical care nursing: consensus statement based on a systematic review and Delphi survey

“…During the COVID-19 pandemic, the number of competent nurses who could provide intensive care nursing care was unknown in Japan. 5 Therefore, it was difficult to respond to the problem of critical care nurse shortage during the pandemic. In the future, nursing associations and academic societies will be able to use the results of this study to assess competency and certify the competent level of critical care nurses.…”

“… 8 9 In addition, SCCN competencies lead to the development of a system to register critical care nurses with competence characteristics. 5 7 Several national and international clinical practice competencies for critical care nurses already exist. 8 9 However, a clear development process and scientifically validated competencies have not been previously developed in Japan.…”

“…The shortage of critical care nurses worldwide during the coronavirus disease 2019 (COVID-19) pandemic became a serious issue 4. In Japan, there is no system to identify the number of nurses who can provide standard critical care; thus, determining the actual shortage of nurses and from where they should be supplied is impossible 5. These issues highlight the lack of clinical practice competencies in standard critical care nursing (SCCN) in Japan.…”

Clinical practice competencies for standard critical care nursing: Consensus statement based on a systematic review and Delphi survey

“…[4] In Japan, there is no system to identify the number of nurses who could provide standard critical care, and thus, it is impossible to determine the actual shortage of nurses and from where they should be supplied. [5] One of the reasons these issues are highlighted is the lack of clinical practice competencies for standard critical care nursing (SCCN) in Japan.…”

“…[8, 9] In addition SCCN competencies would lead to the development of a system to register critical care nurses with those competence characteristics. [5, 7] There are already several national and international clinical practice competencies for critical care nurses. [8, 9] However, a clear development process and scientifically validated competencies have not been previously developed in Japan.…”