Nurse Staffing Level, Length of Work Experience, and Risk of Health Care-Associated Infections Among Hospital Patients: A Prospective Record Linkage Study.

Autor:	Peutere L; School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu.; Finnish Institute of Occupational Health, Helsinki., Terho K; Department of Hospital Hygiene and Infection Control, Turku University Hospital Turku., Pentti J; Department of Public Health, University of Turku, Turku Finland., Ropponen A; Finnish Institute of Occupational Health, Helsinki.; Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden., Kivimäki M; Finnish Institute of Occupational Health, Helsinki.; Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.; Department of Epidemiology and Public Health, University College London, London, UK., Härmä M; Finnish Institute of Occupational Health, Helsinki., Krutova O; Finnish Institute of Occupational Health, Helsinki., Ervasti J; Finnish Institute of Occupational Health, Helsinki., Koskinen A; Finnish Institute of Occupational Health, Helsinki., Virtanen M; School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu.; Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Jazyk:	angličtina
Zdroj:	Medical care [Med Care] 2023 May 01; Vol. 61 (5), pp. 279-287. Date of Electronic Publication: 2023 Mar 20.
DOI:	10.1097/MLR.0000000000001843
Abstrakt:	Background: Nurse understaffing may have several adverse consequences for patients in hospitals, such as health care-associated infections (HAIs), but there is little longitudinal evidence available on staffing levels and HAIs with consideration of incubation times to confirm this. Using daily longitudinal data, we analyzed temporal associations between nurse understaffing and limited work experience, and the risk of HAIs. Methods: The study was based on administrative data of 40 units and 261,067 inpatient periods for a hospital district in Finland in 2013-2019. Survival analyses with moving time windows were used to examine the association of nurse understaffing and limited work experience with the risk of an HAI 2 days after exposure, adjusting for individual risk factors. We reported hazard ratios (HRs) with 95% CIs. Results: Neither nurse understaffing nor limited work experience were associated with the overall risk of HAIs. The results were inconsistent across staffing measures and types of HAIs, and many of the associations were weak. Regarding specific HAI types, 1-day exposure to low proportion of nurses with >3 years of in-hospital experience and low proportion of nurses more than 25 years old were associated with increased risk of bloodstream infections (HR=1.30; 95% CI: 1.04-1.62 and HR=1.40; 95% CI: 1.07-1.83). Two-day exposure to low nursing hours relative to target hours was associated with an increased risk of surgical-site infections (HR=2.64, 95% CI: 1.66-4.20). Conclusions: Data from time-varying analyses suggest that nursing staff shortages and limited work experience do not always increase the risk of HAI among patients. Competing Interests: The authors declare no conflict of interest. (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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