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2017, vol. 51, iss. 4, pp. 126-130
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Hospital infections rate and health staff density in a Neonatology Department
Stopa bolničkih infekcija i angažovanost zaposlenih na neonatološkom odeljenju
aClinical Centre Kragujevac, Clinic for Infectious Diseases, Serbia bClinical Centre Kragujevac, Pediatric Clinic, Serbia cClinical Centre Kragujevac, Pediatric Clinic, Serbia + University of Kragujevac, Faculty of Medical Sciences, Serbia dUniversity of Kragujevac, Faculty of Medical Sciences, Serbia + Clinical Center Kragujevac, Department of Clinical Pharmacology, Serbia
email: drzorana.25@gmail.com
Abstract
Objective. The aim of our study was to compare staffing trends for physicians and nurses with hospital infections (HIs) rate at a neonatology department of tertiary care health facility. Methods. The prospective cohort study was conducted at Neonatology Department, Clinical Centre Kragujevac, Serbia. The incidences of neonates with HIs were calculated for each of the quarters during the 5-year period. The data about the number and structure of staff for each quarter of the study period were collected from the official work schedule lists of the department. Results. This study registered a total of 272 HIs occurring in 264 neonates. The incidence rate of patients with HIs was 13.36% and the incidence density of HIs was 5.85 per 1,000 patient-days. In the observed period the trend of incidence rate of patients with HIs was stable, but the trend of incidence density of HIs was increasing, however without statistical significance. The highest incidence rates of patients with HIs were recorded in the third quarter of all observed years respectively: 17.44% in 2012, 16.74% in 2013, 23.47% in 2014, 18.18% in 2015 and 22.74 in 2016. The average number of nurses in the first shift ranged from 5.0 to 7.0, but in second shift was 3.0 to 4.0 only, and the least number of nurses worked in the third quarter of each year. The average number of physicians in the first shift ranged from 2.33 to 4.47 and they were also the fewest in numbers in the third quarter. We observed strong negative correlation between the average incidence rate of patients with HIs and the average number of nurses in the first shift (r=-0.977, p=0.023). Conclusion. Optimal nurse and physician staffing of neonatal departments in developing countries and the avoidance of inter-quarter variations in number of staff at duty would decrease the incidence of HIs and probably create overall savings of the hospital budget.
Sažetak
Cilj. Cilj ovog istraživanja bio je da se uporede trendovi broja zaposlenih (lekara i medicinskih tehničara) i stope bolničkih infekcija (BI) na neonatološkom odeljenju zdravstvene ustanove tercijarne zdravstvene zaštite. Metode. Sprovedena je prospektivna kohortna studija u Centru za neonatologiju Kliničkog centra Kragujevac, Republika Srbija. Incidencije novorođenčadi sa BI izračunate su za svaki od kvartala tokom perioda od pet godina. Podaci o broju i organizacionoj strukturi osoblja za svaki kvartal istraživačkog perioda prikupljeni su na osnovu zvaničnih rasporeda rada zaposlenih u centru. Rezultati. U ovoj studiji registrovano je ukupno 272 BI kod 264 novorođenčeta. Stopa incidencije kod pacijenata sa BI iznosila je 13,36%, a gustina incidencije BI 5,85 na 1.000 pacijent-dana. U posmatranom periodu trend stope incidencije kod pacijenata sa BI bio je stabilan, ali je trend gustine incidencije BI bio u porastu, mada bez statističke značajnosti. Najveće stope incidencije kod pacijenata sa BI zabeležene su u trećem kvartalu svih posmatranih godina: 17,44% u 2012, 16,74% u 2013, 23,47% u 2014, 18,18% u 2015. i 22,74 u 2016. godini. Prosečan broj zaposlenih medicinskih sestara u prvoj smeni kretao se od 5,0 do 7,0, dok je u drugoj smeni iznosio od 3,0 do 4,0. Najmanje sestara je radilo u trećem kvartalu svake godine. Prosečan broj lekara u prvoj smeni kretao se od 2,33 do 4,47, a takođe najmanji broj radio je u trećem tromesečju. Uočena je snažna negativna korelaciju između prosečne stope incidencije kod pacijenata sa BI i prosečnog broja medicinskih sestara u prvoj smeni (r = -0,977, p = 0,023). Zaključak. Optimalan broj medicinskih sestara i lekara na neonatološkim odeljenjima u zemljama u razvoju, kao i izbegavanje međukvartalnih varijacija u broju zaposlenih može smanjiti incidenciju BI i potencijalno uticati na ukupnu uštedu u budžetu bolnice.
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References
|
|
  
|
Arnold, R., van Teijlingen, E., Ryan, K., Holloway, I. (2014) Understanding Afghan healthcare providers: a qualitative study of the culture of care in a Kabul maternity hospital. BJOG: An International Journal of Obstetrics & Gynaecology, 122(2): 260-267
|
|
|
Bray, K., Wren, I., Baldwin, A., St, L.U., Gibson, V., Goodman, S., Walsh, D. (2010) Standards for nurse staffing in critical care units determined by: The British Association of Critical Care Nurses, The Critical Care Networks National Nurse Leads, Royal College of Nursing Critical Care and In-flight Forum. Nursing in Critical Care, 15(3): 109-111
|
|
1
|
Cimiotti, J.P., Aiken, L.H., Sloane, D.M., Wu, E.S. (2012) Nurse staffing, burnout, and health care-associated infection. American Journal of Infection Control, 40(6): 486-490
|
|
|
Clarke, S.P. (2007) Nurse Staffing in Acute Care Settings: Research Perspectives and Practice Implications. Joint Commission Journal on Quality and Patient Safety, 33(11): 30-44
|
|
|
Couraud, S., Chan, S., Avrillon, V., i dr. (2013) How practical guidelines can be applied in poor countries?: Example of the introduction of a bronchoscopy unit in Cambodia. Rev Pneumol Clin, 69, 244-249
|
|
|
Daud-Gallotti, R.M., Costa, S.F., Guimarães, T., Padilha, K.G., Inoue, E.N., Vasconcelos, T.N., da Silva, C.R.F., Barbosa, E.V., Figueiredo, W.B., Levin, A.S. (2012) Nursing Workload as a Risk Factor for Healthcare Associated Infections in ICU: A Prospective Study. PLoS One, 7(12): e52342
|
|
|
Donovan, E.F., Sparling, K., Lake, M.R., i dr. (2013) Ohio perinatal quality collaborative: The investment case for preventing NICU-associated infections. Am J Perinatol, 30, 179-184
|
|
|
Dowell, D., Manwell, L.B., Maguire, A., i dr. (2005) MEMO investigators: Urban outpatient views on quality and safety in primary care. Healthc Q, 8, 2-8
|
|
3 
|
Horan, T.C., Andrus, M., Dudeck, M.A. (2008) CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. American Journal of Infection Control, 36(5): 309-332
|
|
|
Hugonnet, S., Harbarth, S., Sax, H., Duncan, R.A., Pittet, D. (2004) Nursing resources: a major determinant of nosocomial infection?. Current Opinion in Infectious Diseases, 17(4): 329-333
|
|
|
Kaier, K., Mutters, N.T., Frank, U. (2012) Bed occupancy rates and hospital-acquired infections-should beds be kept empty?. Clinical Microbiology and Infection, 18(10): 941-945
|
|
|
Kelly, D., Kutney-Lee, A., Lake, E. T., Aiken, L. H. (2013) The Critical Care Work Environment and Nurse-Reported Health Care-Associated Infections. American Journal of Critical Care, 22(6): 482-488
|
|
|
McGahan, M., Kucharski, G., Coyer, F. (2012) Nurse staffing levels and the incidence of mortality and morbidity in the adult intensive care unit: A literature review. Australian Critical Care, 25(2): 64-77
|
|
|
Payne, N. R., Carpenter, J. H., Badger, G. J., Horbar, J. D., Rogowski, J. (2004) Marginal Increase in Cost and Excess Length of Stay Associated With Nosocomial Bloodstream Infections in Surviving Very Low Birth Weight Infants. Pediatrics, 114(2): 348-355
|
|
|
Rogowski, J.A., Staiger, D., Patrick, T., Horbar, J., Kenny, M., Lake, E.T. (2013) Nurse Staffing and NICU Infection Rates. JAMA Pediatrics, 167(5): 444
|
|
|
Schwab, F., Meyer, E., Geffers, C., Gastmeier, P. (2012) Understaffing, overcrowding, inappropriate nurse:ventilated patient ratio and nosocomial infections: which parameter is the best reflection of deficits?. Journal of Hospital Infection, 80(2): 133-139
|
|
|
Seo, S., Spetz, J. (2013) Demand for Temporary Agency Nurses and Nursing Shortages. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 50(3): 216-228
|
|
|
Shang, J., Stone, P., Larson, E. (2015) Studies on nurse staffing and health care-associated infection: Methodologic challenges and potential solutions. American Journal of Infection Control, 43(6): 581-588
|
|
|
Shehab, E.E.M. R., El-Sokkary, M.M. A., Bassiouny, M.R., Hassan, R. (2015) Epidemiology of Neonatal Sepsis and Implicated Pathogens: A Study from Egypt. BioMed Research International, 2015: 1-11
|
|
|
Stoll, B. J., Hansen, N., Fanaroff, A. A., Wright, L. L., Carlo, W. A., Ehrenkranz, R. A., Lemons, J. A., Donovan, E. F., Stark, A. R., Tyson, J. E., Oh, W., Bauer, C. R., Korones, S. B., Shankaran, S., Laptook, A. R., Stevenson, D. K., Papile, L.-A. (2002) Late-Onset Sepsis in Very Low Birth Weight Neonates: The Experience of the NICHD Neonatal Research Network. Pediatrics, 110(2): 285-291
|
|
|
Tekin, R., Dal, T., Pirinccioglu, H., Erisir, O.S. (2013) A 4-Year Surveillance of Device-associated Nosocomial Infections in a Neonatal Intensive Care Unit. Pediatrics & Neonatology, 54(5): 303-308
|
|
|
Weaver, S.J., Weeks, K., Pham, J.C., Pronovost, P.J. (2014) On the CUSP stop BSI: Evaluating the relationship between central line-associated blood stream infection rate and patient safety climate profile. AJIC, 42, 203-208
|
|
|
|
|