Healthcare Epidemiology: Hospital Staffing and Health Care–Associated Infections: A Systematic Review of the Literature

Stone, Patricia W.; Pogorzelska, Monika; Kunches, Laureen M.; Hirschhorn, Lisa R.

doi:10.1086/591696

Cited by 89 publications

(77 citation statements)

References 62 publications

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“…This study showed that higher nursing care hours was associated with fewer CLABSIs and shorter LOS, which is consistent with trends in previous studies [33]. Moreover, the results also suggest a nursestaffing benchmark to consider.…”

Section: Discussionsupporting

confidence: 91%

Impact of Nursing Staffing on Patient Outcomes in Intensive Care Unit

Hsu

Chang²,

Thompson

et al. 2013

J Nurs Care

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Background: The impact of nursing care on patient outcomes is not well understood. The objective of this study is to assess the effects of nursing care hours per patient day, nursing skill mix, and nurse turnover on central line-associated bloodstream infection (CLABSI) rates, length of stay (LOS), and mortality in the context of intensive care units (ICUs) using interventions to reduce bloodstream infections and improve patient safety, teamwork and interdisciplinary communication.

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Section: Discussionsupporting

confidence: 91%

Impact of Nursing Staffing on Patient Outcomes in Intensive Care Unit

Hsu

Chang²,

Thompson

et al. 2013

J Nurs Care

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“…Staffing levels and composition in dialysis facilities are ultimately modifiable factors that can be optimized and thereby improve patient outcomes [38, 39]. Structural staffing issues, specifically inadequate nurse staffing in acute care hospitals, have been linked to heightened risk of infection [40], mortality [41], and other adverse consequences [42-45]. Adequacy of dialysis clinic staffing and quality of care are linked [46], although what constitutes “adequate” staffing at dialysis facilities has not yet been defined, particularly with respect to ameliorating hospitalization risk [47].…”

Section: Discussionmentioning

confidence: 99%

Association of US Dialysis Facility Staffing with Profiling of Hospital-Wide 30-Day Unplanned Readmission

Chen¹,

Rhee²,

Şentürk³

et al. 2019

Kidney Dis

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Background: Unplanned hospital readmissions are a major source of morbidity among dialysis patients, in whom the risk of hospital readmission is exceptionally high. The contribution of dialysis facility staffing to hospital readmission has been largely overlooked. Methods: Using annual data of dialysis patients from the United States Renal Data System from 2010 to 2013, we assessed dialysis facilities with a significantly worse (SW) and facilities with a nonsignificant (NS) standardized readmission ratio (SRR). SRR estimates were risk adjusted for patient factors, past year comorbidities, and index hospitalization characteristics. Facility staffing variables were compared between 2 exposure groups: facilities with SW and NS SRRs. Four measures of staffing, including patient-to-staffing ratio, were compared between SW and matched NS facilities. Results: About 136,000–148,000 dialysis patients with 269,000–319,000 index hospital discharges were used to identify facilities with SW and facilities with NS SRR annually. Approximately 3–4% of facilities were identified as having SW SRR among > 5,000 facilities annually. The percent of nurses-to-total staff was significantly lower in 2010 for SW facilities than in matched NS facilities (42.5 vs. 45.6%, p = 0.012), but this disparity was attenuated by 2013 (44.8 vs. 44.7%, p = 0.949). There was a higher patient-to-nurse ratio for SW facilities than for NS facilities (mean 16.4 vs. 15.2, p = 0.038) in 2010 as well, and the disparity was reduced by 2013. The trends were similar for patient-to-total staff and patient-to-registered nurse, but not statistically significant. Conclusions: This study found that dialysis facilities with SW 30-day readmission rates had lower proportions of nurses-to-total staff and higher patient-to-nurse ratios, but this disparity improved in recent years. Additional research is warranted focusing on how evidence-based staffing at dialysis facilities can contribute to reduction of hospital readmission, and this knowledge is needed to inform clinical practice guidelines and policy decisions regarding optimal dialysis patient staffing.

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“…La razón entre camas de UCI y personal de enfermería, y el lavado de manos son factores independientes que tienen un alto impacto en la incidencia de infecciones asociadas al cuidado de la salud 18,19 . El estudio INICC y otros han mostrado la baja …”

Section: Discussionunclassified