Do staffing and workload levels influence the risk of new acquisitions of meticillin-resistant Staphylococcus aureus in a well-resourced intensive care unit?

Kong, Fiona; Cook, David; Paterson, David L.; Whitby, Michael; Clements, Archie

doi:10.1016/j.jhin.2011.10.008

Cited by 6 publications

(7 citation statements)

References 43 publications

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Section: Resultsmentioning

confidence: 99%

“…The flow of studies through the review process and the number of studies excluded are shown in The findings from the 12 articles met the inclusion criteria and were considered to be relevant (Table 1). Of these, 66.7% (8/12) investigated MRSA-associated infection or colonization [9][10][11][12][13][14][15][16], one studied MRSA and extended-spectrum b-lactamase-producing Gram-negatives [5], one studied C. difficile [11], one studied Enterobacter cloacae [12], and one studied different infection types caused by varying agents (pneumonia and bloodstream infections) [17]. The median BO rate was 81.2%.…”

Section: Resultsmentioning

confidence: 99%

“…In contrast to these studies, some (25%) found divergent results. One study, using a multivariate logistic regression including 61 MRSA patients (colonization and infections), found no evidence that intensive-care unit staffing or workload predicts the risk of MRSA acquisition [14]. Sakamoto et al [15] used monthly time-series data to determine simple univariate correlation coefficients, and showed that BO rates (r = 0.033, p 0.199), patient/nurse ratio (r = )0.769, p 0.295) and colonization pressure (r = 0.006, p 0.571) were not significantly associated with MRSA incidence density rates.…”

Section: Resultsmentioning

confidence: 99%

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Bed occupancy rates and hospital-acquired infections—should beds be kept empty?

Kaier

Mutters

Frank

2012

Clinical Microbiology and Infection

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Clin Microbiol Infect 2012; 18: 941–945 Abstract There is growing evidence that bed occupancy (BO) rates, overcrowding and understaffing influence the spread of hospital‐acquired infections (HAIs). In this article, a systematic review of the literature is presented, summarizing the evidence on the adverse effects of high BO rates and overcrowding in hospitals on the incidence of HAIs. A Pubmed database search identified 179 references, of which 44 were considered to be potentially relevant for full‐text review. The majority (62.9%) focused on methicillin‐resistant Staphylococcus aureus‐associated infection or colonization. Only 12 studies were found that provided a statistical analysis of the impact of BO on HAI rates. The median BO rate of the analysed studies was 81.2%. The majority of studies (75%) indicated that BO rates and understaffing directly influence the incidence of HAIs. Only three studies showed no significant association between BO rates and the incidence of HAIs. Interestingly, only one of the included studies detected a seasonal trend in the BO rate. The present review shows an association between BO rates and the spread of HAIs in various settings. Because the evidence on this topic is limited, we conclude that further research is needed in order to analyse the rationale of a threshold BO rate, because keeping beds empty is comparatively costly.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Bed occupancy rates and hospital-acquired infections—should beds be kept empty?

Kaier

Mutters

Frank

2012

Clinical Microbiology and Infection

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“…We considered that potential risk factors for this MRSA transmission was possible fatigue (long shifts) and a mild upper respiratory infection with nasal discharge among one of the MRSA colonised HCW. The risks posed by high workloads can be mitigated by good compliance with infection control measures, training and adequate staffing ratios in the ICU [ 19 ]. In addition, it’s likely that having a concurrent respiratory infection leads one to be more likely to spread MRSA.…”

Section: Discussionmentioning

confidence: 99%

Healthcare-associated transmission of Panton-Valentine leucocidin positive methicillin-resistant Staphylococcus aureus: the value of screening asymptomatic healthcare workers

Papastergiou

Tsiouli

2018

BMC Infect Dis

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BackgroundThree patients hospitalised in the coronary care unit of a general district hospital (England, UK) were tested positive for Panton-Valentine leucocidin methicillin-resistant Staphylococcus aureus colonisation during their routine weekly screening for methicillin-resistant Staphylococcus aureus (MRSA). The isolates were indistinguishable and all three patients have previously had negative screening tests. The outbreak investigation team considered exploring the possibility of PVL-MRSA transmission from members of staff to the patients and potentially between members of staff.MethodAs part of the investigations, healthcare workers on coronary care unit and intensive care unit were screened for MRSA carriage.ResultsAmong 134 screened healthcare workers, five staff members (3.7%) were MRSA colonised. Among these isolates, four were Panton-Valentine leukocidin positive. However, only two healthcare workers had an indistinguishable isolate with the isolate identified among the colonised patients. Decolonisation treatment was offered to all colonised patients and healthcare workers.ConclusionIn low MRSA prevalence settings, healthcare workers may be a reservoir of MRSA and an important potential source of transmission to patients. Screening and decolonisation of colonised healthcare workers may provide a valuable strategy in managing linked hospital acquisitions and reduce the risk of occupationally acquired complications. MRSA mass screen of healthcare workers should be considered in transmission with a strain that has a potentially increased virulence, such as Panton-Valentine leucocidin methicillin-resistant Staphylococcus aureus.

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“…Insufficient nurse staffing might increase the rate of risk for infections (Kong, Cook et al 2012). A US study tried to determine relationship between number of nursing staff and rates of hospital-acquired infections and nurse.…”

Section: Health Care Providersmentioning

confidence: 99%

Methods of Preventing Hospital Acquired Infection

Bashar¹

2019

ABCMed

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Hospital-acquired infections can increase the rate of morbidity and mortality as well as medical costs. Nosocomial infection is spread by various ways such as surgical, intravenous catheters, surface contact (like as hands) and also through the air. Some interventions include appropriate hand and surface decontamination, sufficient staffing, improved ventilator management, usage of coated central venous and urinary catheters have all been linked with considerably lower rate of nosocomial infection. Multiple interventions simultaneously are required for comprehensive infection control and multiple actions may be given better outcome rather than a single action. Some multiple infection control protocols will possibly show more effective result instead of employing a single or few strategies. Several non-pharmacological interventions to prevent HAIs will reduce the requirement for prolonged or multiple-drug antibiotic courses for infected patients. And lower antibiotic usage will decrease risk of antibiotic-resistant organisms and may improve effectiveness of antibiotics therapy to patients with acquired infections.

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Do staffing and workload levels influence the risk of new acquisitions of meticillin-resistant Staphylococcus aureus in a well-resourced intensive care unit?

Cited by 6 publications

References 43 publications

Bed occupancy rates and hospital-acquired infections—should beds be kept empty?

Bed occupancy rates and hospital-acquired infections—should beds be kept empty?

Healthcare-associated transmission of Panton-Valentine leucocidin positive methicillin-resistant Staphylococcus aureus: the value of screening asymptomatic healthcare workers

Methods of Preventing Hospital Acquired Infection

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