目标：确定美国ICU中使用的跨专业人员配置模式集群。
方法：潜在类分析。
方法：美国成人ICU。
方法：无。
方法：无。
方法：我们使用了来自人员配备调查的数据，该调查询问了提供者（强化和非强化）的受访者（n=596个ICU），护理,呼吸治疗师,和临床药师的可用性和作用。我们使用潜在的类别分析来识别描述跨专业人员配置模式的集群，然后比较了集群中的ICU和医院特征。
结果：我们确定了三个集群是最佳的。大多数ICU（54.2％）处于第1组（“较高的总体人员配备”），其特征是较高的可能性提供良好的提供商覆盖率（无论是密集的[现场24小时/天]还是非密集的[ICU团队独家下的订单，高级实践提供者的存在，和接受培训的医生])，护理领导(主管护士在场，护士教育者,和经理)，和床边护理支持(具有注册护理学位的护士，每个护士的病人更少，和护理助手的可用性)。三分之一(33.7%)属于第二组(“强化医生覆盖率和护理领导力较低，较高的床旁护理支持\“)和12.1%在第3组(\“较高的提供者覆盖率和护理领导力，下床边护理支持\“)。临床药师在第1组(99.4%)中更为常见，但在所有ICU中超过85％;呼吸治疗师几乎是普遍的。第1组ICU较大（中位数为20张病床与簇2和簇3中分别为15和17；p<0.001)，和较大的（>250床：80.6%vs.66.1%和48.5%；p<0.001)，非营利组织（75.9%与69.4%和60.3%；p<0.001）医院。24小时/天的远程医疗使用在第3组单位中更为常见（71.8%与11.7%和14.1%；p<0.001)。
结论：超过一半的美国ICU总体人员配备较高。其他人倾向于拥有更高的提供者存在和护理领导力或更高的床边护理支持，但不是两者都有。
OBJECTIVE: To identify interprofessional staffing pattern clusters used in U.S. ICUs.
METHODS: Latent class analysis.
METHODS: Adult U.S. ICUs.
METHODS: None.
METHODS: None.
METHODS: We used data from a staffing survey that queried respondents (n = 596 ICUs) on provider (intensivist and nonintensivist), nursing, respiratory therapist, and clinical pharmacist availability and roles. We used latent class analysis to identify clusters describing interprofessional staffing patterns and then compared ICU and hospital characteristics across clusters.
RESULTS: We identified three clusters as optimal. Most ICUs (54.2%) were in cluster 1 (\"higher overall staffing\") characterized by a higher likelihood of good provider coverage (both intensivist [onsite 24 hr/d] and nonintensivist [orders placed by ICU team exclusively, presence of advanced practice providers, and physicians-in-training]), nursing leadership (presence of charge nurse, nurse educators, and managers), and bedside nursing support (nurses with registered nursing degrees, fewer patients per nurse, and nursing aide availability). One-third (33.7%) were in cluster 2 (\"lower intensivist coverage & nursing leadership, higher bedside nursing support\") and 12.1% were in cluster 3 (\"higher provider coverage & nursing leadership, lower bedside nursing support\"). Clinical pharmacists were more common in cluster 1 (99.4%), but present in greater than 85% of all ICUs; respiratory therapists were nearly universal. Cluster 1 ICUs were larger (median 20 beds vs. 15 and 17 in clusters 2 and 3, respectively; p < 0.001), and in larger (> 250 beds: 80.6% vs. 66.1% and 48.5%; p < 0.001), not-for-profit (75.9% vs. 69.4% and 60.3%; p < 0.001) hospitals. Telemedicine use 24 hr/d was more common in cluster 3 units (71.8% vs. 11.7% and 14.1%; p < 0.001).
CONCLUSIONS: More than half of U.S. ICUs had higher staffing overall. Others tended to have either higher provider presence and nursing leadership or higher bedside nursing support, but not both.
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