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The Role of Nurse Understaffing in Nosocomial Viral Gastrointestinal Infections on a General Pediatrics Ward

Published online by Cambridge University Press:  02 January 2015

Jacob Stegenga ,
Erica Bell  and
Anne Matlow
Jacob Stegenga
Affiliation:
Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
Erica Bell
Affiliation:
Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
Anne Matlow*
Affiliation:
Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada Department of Pediatric and Laboratory Medicine, The Hospital for Sick Children; and the Departments of Pediatrics and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
*
Infection Prevention and Control Program, The Hospital for Sick Children, 555 University Avenue, Toronto, M5G 1X8 Ontario, Canada
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Abstract

Objective:

To examine the relationship between nurse staffing levels and the rate of nosocomial viral gastrointestinal infections (NVGIs) in a general pediatrics population.

Design:

Retrospective descriptive study.

Setting:

A general pediatrics ward at The Hospital for Sick Children in Toronto, Ontario, Canada, a 320-bed, tertiary-care pediatric institution.

Results:

Forty-three NVGIs were detected in 37 patients of 2,929 admissions (1.3%). The monthly NVGI rate correlated significantly with the monthly night patient-to-nurse ratio (r = 0.56) and the monthly day patient-to-nurse ratio (r = 0.50). The nursing hours per patient-day during the preinfection period (PIP) were significantly lower than those during the nonpreinfection period (NPIP; 12.5 vs 13.0). There was no difference between the PIP and the NPIP day patient-to-nurse ratios (3.31 vs 3.32), but there was a significant difference between the PIP and the NPIP night patient-to-nurse ratios (3.26 vs 3.16). The incidence of NVGIs in the 72-hour period after any day when the nursing hours per patient-day were less than 10.5 was 6.39 infections per 1,000 patient-days, compared with 2.17 infections per 1,000 patient-days in periods with more than 10.5 nursing hours per patient-day (rate ratio, 2.94; 95% confidence interval, 2.16 to 4.01).

Conclusion:

Nurse understaffing contributed to an increased NVGI rate in our general pediatrics population, and should be assessed as a risk factor in outbreak investigations.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 23 , Issue 3 , March 2002 , pp. 133 - 136
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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References

1.Haley, RW, Bregman, DA. The role of understaffing and overcrowding in recurrent outbreaks of staphylococcal infection in a neonatal special-care unit. J Infect Dis 1982;145:875–885.CrossRefGoogle Scholar
2.Heseltine, P. Too many or too few hands? Infect Control Hosp Epidemiol 1999;20:595–597.Google ScholarPubMed
3.Duncan, RA, Levine, A, Willey, S, et al. Nursing staffing and central venous catheter-related bloodstream infections (CVC-BSIs) in a changing surgical intensive care unit (SICU). Presented at the Ninth Annual Meeting of the Society for Healthcare Epidemiology of America; April 18-20,1999; San Francisco, CA Abstract.Google Scholar
4.Fridkin, SK, Pear, SM, Williamson, TH, Galgiani, JN, Jarvis, WR. The role of understaffing in central venous catheter-associated bloodstream infections. Infect Control Hosp Epidemiol 1996;17:150–158.Google ScholarPubMed
5.Archibald, LK, Manning, ML, Bell, LM, Banerjee, S, Jarvis, WR. Patient density, nurse-to-patient ratio and nosocomial infection risk in a pediatric cardiac intensive care unit. Pediatr Infect Dis J 1997;16:1045–1048.CrossRefGoogle Scholar
6.Kovner, C, Gergen, PJ. Nurse staffing levels and adverse events following surgery in U.S. hospitals. Image J Nurs Sch 1998;30:315–321.Google Scholar
7.Harbarth, S, Sudre, P, Dharan, S, Cadenas, M, Pittet, D. Outbreak of Enterobacter cloacae related to understaffing, overcrowding and poor hygiene practices. Infect Control Hosp Epidemiol 1999;20:598–603.Google Scholar
8.Loeb, M, Salama, S, Armstrong-Evans, M, et al. Nursing workload was not an independent risk factor for nosocomial colonization with VRE. Presented at the Ninth Annual Meeting of the Society for Healthcare Epidemiology of America; April 18-20,1999; San Francisco, CA Abstract 3.Google ScholarPubMed
9.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128–140.CrossRefGoogle ScholarPubMed
10.Rosner, BA. Fundamentals of Biostatistics, 4th ed. Scarborough, Ontario, Canada: Wadsworth Publishing; 1995:592–597.Google Scholar
11.Albert, RF, Condie, F. Handwashing patterns in medical intensive-care units. N Engl J Med 1981;304:1465–1466.CrossRefGoogle ScholarPubMed
12.Larson, E. Compliance with isolation techniques. Am J Infect Control 1981;11:221–225.CrossRefGoogle Scholar
13.Pittet, D, Mourouga, P, Perneger, TV. Compliance with handwashing in a teaching hospital: infection control program. Ann Intern Med 1999; 130:126–130.CrossRefGoogle Scholar
14.Preston, GA, Larson, EL, Stamm, WE. The effect of private isolation rooms on patient care practices, colonization and infection in an intensive care unit. Am J Med 1981;70:641–645.CrossRefGoogle Scholar
15.Haley, RW, Cushion, NB, Tenover, FC, et al. Eradication of endemic methicillin-resistant Staphylococcus aureus infections from a neonatal intensive care unit. J Infect Dis 1995;171:614–624.CrossRefGoogle ScholarPubMed
16.Trundle, CM, Farrington, M, Anderson, L, Redpath, CK. GRASPing infection: a workload measurement tool for infection control nurses. J Hosp Infect 2001;49:215–221.CrossRefGoogle ScholarPubMed