Primary Nursing in Intensive Care Units.
Lars Krüger, Thomas Mannebach, Francesco Squiccimarro and 12 others
PMID 41556718WHAT IT FOUND
Primary nursing increased ICU nursing organisation scores in one unit, but the other unit only partly reached it and some patient and care process measures fell.
Key findings
01The overall ICU nursing profile in ICU 1 increased from 44.5% to 83.0%.
02ICU 2's overall profile was 71.5% and 69.0% at the later measurement points, below the paper's threshold for primary nursing.
03In ICU 2, patient participation and relationship with the primary nurse decreased, from 66.0% and 47.0% to 49.5% and 33.0%.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study followed the same units over time, so it cannot show that Primary Nursing caused the changes. It measured nursing organisation and process indicators, not patient clinical outcomes such as complications, length of stay or mortality. Patients who were mechanically ventilated or sedated were excluded, and their relatives were not asked, so the sickest ICU patients are not represented. The IzEP(c) tool was used only in German and administered in interviews, which could introduce interviewer bias. ICU 2 had periods with fewer primary nurses because of illness, training and part-time management, limiting generalisability. Primary nursing started on the third day of the ICU stay, not at admission. Only quantitative data were analysed, and the evaluation was limited to percentage calculations.
Declared interests
The authors declared no conflicts of interest. The study was financed by the own funds of the Heart and Diabetes Center NRW, Ruhr University Bochum.
The easy way to misread this
Do not read the higher ICU profile scores as proof that Primary Nursing improves patient outcomes. The study measured organisation and process indicators, followed the same units over time, and excluded patients who were mechanically ventilated or sedated.