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Fewer nurses lead to more VAP cases

Quality Improvement Monitor, July 27, 2007

More patients on respirators get pneumonia when fewer nurses are on duty in an intensive care unit, according to a new study reported on in The New York Times.

The study, published July 19 online in Critical Care, ventilator-associated pneumonia (VAP) causes significant mortality, increases hospital stay by as much as 50 days and leads to substantial extra costs, the paper reported.

Researchers found that VAP was associated with an average of .78 nurses per patient two to four days before early onset VAP and .42 nurses per patient two to four days before late-onset VAP. A low nurse-to-patient ratio was a critical risk factor for VAP, the Times said.

Stéphane Hugonnet, lead author of the study, told the Times that a key factor for the increase in VAP is that "nurses have too much work to do and don't comply with basic hygiene rules."

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