Is Nurse Workforce Sufficient in Intensive Care Units in Turkey. Results of the Multicenter Karia Study
Ayse Uyan, Meltem Tasbakan, Bilgin Arda, Sercan Ulusoy, O. R. Sipahi, G. Durmus, Nurbanu Sezak, Fatmanur Pepe, Turkkan Kaygusuz, Nefise Oztoprak, K. Ozdemir, Firdevs Aksoy, S. Erol, M. Meric, Ahsen Oncul, Sabahat Cagan Aktas, Hulya Caskurlu, G Çelebi, O. Kandemir, Selcuk Ozger, R. Harman, Kubra Demiray, Alpay Ari, Sevil Alkan Ceviker, Ilknur Esen Yildiz, Sirin Menekse, G. Senol, Sema Sari, Mustafa Dogan, K. Ugurlu, Mustafa Arslan, Irem Akdemir, Pinar Firat, Yesim Kurekci, Derya Caglayan, Mehmet Ucar, Ramazan Gozukucuk, Habibe Tulin Elmaslar Mert, Handan Alay, Haluk Erdogan, Aslihan Demirel, Nilgun Dogan, Funda Kocak, Emre Guven, Guleser Unsal, Hilal Sipahi
article (Uluslararası, Hakemli) | Yazar(lar): Ayse Uyan, Meltem Tasbakan, Bilgin Arda, Sercan Ulusoy, O. R. Sipahi, G. Durmus, Nurbanu Sezak, Fatmanur Pepe, Turkkan Kaygusuz, Nefise Oztoprak, K. Ozdemir, Firdevs Aksoy, S. Erol, M. Meric, Ahsen Oncul, Sabahat Cagan Aktas, Hulya Caskurlu, G Çelebi, O. Kandemir, Selcuk Oz
Introduction: In this multicenter study, we analysed the magnitude of healthcare worker (HCW) [infection control practitioner (ICP), nurses and others] workforce in hospitals participated in the study.
Materials and Methods: This study was performed in 41 hospitals (with intensive care units-ICU) located in 22 cities from seven regions of Turkey. We analysed the ICP workforce, nursing and auxiliary HCW (AHCW) workforce in ICUs, number of ICU beds and occupied beds in four different days [two of which were in summer during the vacation time (August 27 and 31, 2016) and two others in autumn (October 12 and 15, 2016)]. The Turkish Ministry of Health (TMOH) requires two patients per nurse in level 3 ICUs, three patients per nurse in level 2 ICUs and five patients per nurse in level 1 ICUs. There is no standardization for the number of AHCW in ICUs. Finally, one ICP per 150 hospital beds is required by TMOH.
Results: The total number of ICUs, ICU beds and ICPs were 214, 2377 and 111, respectively in he 41 participated centers. The number ICPs was adequate only in 12 hospitals. The percentage of nurses whose working experience was <1 year, was; 19% in level 1 ICUs, 25% in level 2 ICUs and 24% in level 3 ICUs. The number of patients per nurse was mostly <5 in level 1 ICUs whereas the number of patients per nurse in level 3 ICUs was generally >2. The number of patients per other HCW was minimum 3.75 and maximum 4.89 on weekdays and on day shift while it was minimum 5.02 and maximum 7.7 on weekends or on night shift. When we compared the number of level 1, 2 and 3 ICUs with adequate nursing workforce vs inadequate nursing workforce, the p value was <0.0001 at all time points except summer weekend night shift (p=0.002).
Conclusion: Our data suggest that ICP workforce is inadequate in Turkey. Besides, HCW workforce is inadequate and almost 1/4 of nurses are relatively inexperienced especially in level 3 ICUs. Turkish healthcare system should promptly make necessary arrangements for adequate HCW staffing.