Nurse staffing and cost of care in adult intensive care units in a university hospital in Thailand

Abstract

Decisions about nurse staffing levels in intensive care units (ICUs) should be guided by research to ensure optimal outcomes. This descriptive correlational study in a large Thai hospital was designed to evaluate the effect of nurse staffing levels on the costs of care, in terms of medical care cost per patient day and health personnel cost per patient day, in ICUs. The costing data were collected prospectively from the records of 242 critically ill patients while the nurse staffing levels were extracted from hospital management reports. The findings showed that a nurse staffing model with a higher number of registered nurses (RNs) led to an increase in the health personnel cost per patient day. However, a greater number of RNs was associated with improved patient safety and efficiency, thereby reducing the length of stay and the costs of care in the long term. This study provides evidence to support decisions by hospital administrators concerning RN staffing levels. © 2008 The Authors Journal Compilation © 2008 Blackwell Publishing Asia Pty Ltd.