Peutere, Laura;
Terho, Kirsi;
Pentti, Jaana;
Ropponen, Annina;
Kivimäki, Mika;
Härmä, Mikko;
Krutova, Oxana;
... Virtanen, Marianna; + view all
(2023)
Nurse Staffing Level, Length of Work Experience, and Risk of Health Care–associated Infections Among Hospital Patients:
A Prospective Record Linkage Study.
Medical Care
10.1097/MLR.0000000000001843.
(In press).
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Abstract
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.
| Type: | Article |
|---|---|
| Title: | Nurse Staffing Level, Length of Work Experience, and Risk of Health Care–associated Infections Among Hospital Patients: A Prospective Record Linkage Study |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1097/MLR.0000000000001843 |
| Publisher version: | https://doi.org/10.1097/MLR.0000000000001843 |
| Language: | English |
| Additional information: | © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CC-BY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| Keywords: | Administrative data, health care–associated infection, nurses, hospital staffing, work experience. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Mental Health of Older People |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10167441 |
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