Year-end Sale % OFF 
Abstract
IntroductionNurse understaffing is frequently hypothesized as a potential risk factor for healthcare-associated infections (HAI). This study aimed to evaluate the role of nursing workload in the occurrence of HAI, using Nursing Activities Score (NAS).MethodsThis prospective cohort study enrolled all patients admitted to 3 Medical ICUs and one step-down unit during 3 months (2009). Patients were followed-up until HAI, discharge or death. Information was obtained from direct daily observation of medical and nursing rounds, chart review and monitoring of laboratory system. Nursing workload was determined using NAS. Non-compliance to the nurses’ patient care plans (NPC) was identified. Demographic data, clinical severity, invasive procedures, hospital interventions, and the occurrence of other adverse events were also recorded. Patients who developed HAI were compared with those who did not.Results195 patients were included and 43 (22%) developed HAI: 16 pneumonia, 12 urinary-tract, 8 bloodstream, 2 surgical site, 2 other respiratory infections and 3 other. Average NAS and average proportion of non compliance with NPC were significantly higher in HAI patients. They were also more likely to suffer other adverse events. Only excessive nursing workload (OR: 11.41; p: 0.019) and severity of patient’s clinical condition (OR: 1.13; p: 0.015) remained as risk factors to HAI.ConclusionsExcessive nursing workload was the main risk factor for HAI, when evaluated together with other invasive devices except mechanical ventilation. To our knowledge, this study is the first to evaluate prospectively the nursing workload as a potential risk factor for HAI, using NAS.
Highlights
Nurse understaffing is frequently hypothesized as a potential risk factor for healthcare-associated infections (HAI)
Invasive procedures have been the subject of studies on the epidemiology of healthcare-associated infection (HAI) and are considered traditional risk factors, such as central venous catheters for bloodstream infections and mechanical ventilation for pneumonias [1,2]
Considering that in the intensive care units 2 beds were assigned to each nursing healthcare workers (HCW), we considered that an average Nursing Activities Score (NAS) $51% per patient during the follow-up up indicated an excessive workload
Summary
Nurse understaffing is frequently hypothesized as a potential risk factor for healthcare-associated infections (HAI). Invasive procedures have been the subject of studies on the epidemiology of healthcare-associated infection (HAI) and are considered traditional risk factors, such as central venous catheters for bloodstream infections and mechanical ventilation for pneumonias [1,2]. Part of these infections is caused by exogenous contamination, linked to inadequate practices of sterile technique. Implementation of ‘‘bundles’’ that include a limited number of interventions that are well backed by a high level of scientific evidence, are one of the main strategies of prevention [6]. Individually studied interventions may not be effective when implemented in a bundle [7]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
