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.

Keywords: extracorporeal membrane oxygenation; intensive care units; mechanical ventilation; workforce.

Figure 1

The response rate of the postal survey in each prefecture.

Figure 2

Nursing activities for specific procedures.Note: “Always” means that the nurse always undertook the procedure. “Never” means that the nurse never undertook the procedure and that other professionals, such as physicians, undertook the task. Missing data were included in this analysis. Abbreviations: MV, mechanical ventilator; VV-ECMO, veno-venous extracorporeal membrane oxygenation; ^† under a pre-prescribed protocol.