Improving hospital nurse staffing during the pandemic: Implementation of the 2019 Fund for Health Care Staff in Belgium

Heede, Koen Van den; Balcaen, Koen; Bouckaert, Nicolas; Bruyneel, Luk; Cornelis, Justien; Sermeus, Walter; Voorde, Carine Van de

doi:10.1016/j.healthpol.2022.11.013

Cited by 10 publications

(8 citation statements)

References 26 publications

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“…Our result indicated that each patient received a total of 4.16 h of nursing care per day delivered by nurses, LPN and HCA which is in line with previous recommendations (Jette et al, 2004;Van Den Heede et al, 2019). Specifically, it was suggested that there are 1.53 more chances to have better outcomes in rehabilitation when the total hours of nursing care per day is higher than 3.5 (Jette et al, 2004).…”

Section: Discussionsupporting

confidence: 87%

“…In conclusion, sufficient and qualified personnel practicing in teams to their full scope of practice can increase patient safety. Our literature review shows that a small number of past studies have been conducted in rehabilitation units, which highlights the importance of the present study (Jette et al, 2004, Van Den Heede et al, 2019.…”

Section: Association Between the Organization Of Nursing Services And...mentioning

confidence: 79%

“…Specifically, it was suggested that there are 1.53 more chances to have better outcomes in rehabilitation when the total hours of nursing care per day is higher than 3.5 (Jette et al, 2004). Other rehabilitation settings have been found to benefit from an average of 5.12 h per patient day (Van Den Heede et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

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Staffing, teamwork and scope of practice: Analysis of the association with patient safety in the context of rehabilitation

Jomaa

Dubois

Caron

et al. 2021

Journal of Advanced Nursing

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Aims:To describe the organization of nursing services (staffing, scope of practice, teamwork) and its association with medication errors and falls, in rehabilitation units.Background: The healthcare system is greatly impacted by the ageing population and the complexity of care associated with chronic diseases. It is therefore necessary to have enough staff who are using their full scope of practice and who are operating in a favourable working environment. However, these conditions are not always met, which can lead to threats to patient safety. Design:A correlational descriptive study. Methods:Staffing data and reported safety incidents were collected by shift from 01 October 2019 until 15 January 2020 in five rehabilitation units. In addition, a total of 75 nursing staff members responded to a missed care and teamwork survey.Descriptive analysis and logistic regression analysis were performed. Results:The mean staff hours per patient shift was 1.39 (SD = 0.60). The teams reported a global missed care score as 'rarely missed' at 1.14 (SD = 0.07) and a moderate teamwork score at 3.36 (SD = 0.58) on a five-point scale. The safety incidents decreased 10-fold with a predominance of bachelor compared with technician nurses and decreased by 67% when there was an increase of 1 h of care per patient shift. Conclusions:This study showed that the organization of nursing services in the observed rehabilitation units is characterized by a moderate staffing intensity, a moderate perception of teamwork level and a relatively low level of missed care. It indicated the key role of the staffing in reducing the risk of occurrence of safety incidents. Future research specific to rehabilitation hospitals are greatly needed to improve patient outcomes in this setting.Impact: Nurse Managers should consider all the aspects of the organization of nursing services (staffing, scope of practice and teamwork) in their efforts to improve patient safety in rehabilitation settings. A central finding of this study is that the staffing intensity, the proportion of bachelor prepared nurses and the proportion of agency staff were positively associated with a reduction of safety incidents.

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Section: Discussionsupporting

confidence: 87%

Section: Association Between the Organization Of Nursing Services And...mentioning

confidence: 79%

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Staffing, teamwork and scope of practice: Analysis of the association with patient safety in the context of rehabilitation

Jomaa

Dubois

Caron

et al. 2021

Journal of Advanced Nursing

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“…Measures that compute nurse staffing levels by dividing the total number of full-time equivalent nursing staff members by patient days or by the total number of beds are too crude. Patient-to-nurse ratio or nursing hours per patient day are better indicators to estimate nurse staffing levels and their impact on the quality of care [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Clusters in Belgian Nursing Homes: Impact of Facility Characteristics and Vaccination on Cluster Occurrence, Duration and Severity

Dequeker

Callies

Catteau

et al. 2023

Viruses

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COVID-19 severely affected nursing home residents from March 2020 onwards in Belgium. This study aimed to model the impact of vaccination and facility characteristics on cluster occurrence, duration and severity in this setting. Possible clusters were identified between June 2020 and January 2022, based on the Belgian COVID-19 surveillance in nursing homes. Median attack rates (AR) among residents and staff, case hospitalization rates (CHR) and case fatality rates (CFR) were calculated. A negative binomial model was used to identify the association between nursing home characteristics and the number of cases, hospital admissions and deaths and the duration of the cluster. A total of 2,239 clusters were detected in more than 80% of nursing homes. Most of these (62%) occurred before the start of COVID-19 vaccination (end of December 2020). After vaccination, the number of clusters, the AR among residents and staff, the CHR and the CFR dropped. Previous cluster(s) and vaccination decreased the number of cases, hospital admissions and deaths among residents. Previous cluster experience and having started vaccination were protective factors. We recommend continued implementation of targeted interventions such as vaccination, large-scale screening and immediate implementation of additional infection prevention and control measures.

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“…Interestingly, the clear increase of all HAIs with the exception of SSIs in 2020 is indicative of the COVID-19 pandemic during which the risk of HAI rose 23 and many nonurgent elective surgeries were postponed. 24 Identical patterns were described in the United States, 25,26 and in the countrywide HABSI surveillance. 27 A similar trend applied to the case fatality risk, which was the highest in 2020 (21.05%).…”

Section: Discussionmentioning

confidence: 96%

Prevalence of hospital-associated infections and its association with discharge destinations and hospital readmissions in Brussels, Belgium, from 2008 to 2020: A hospital-based, cross-sectional study

Mahieu,

Yannart,

Dauby

et al. 2023

Infect. Control Hosp. Epidemiol.

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Objectives: To examine time trends of hospital-associated infections (HAIs) in people living in the Brussels–Capital Region, and to evaluate the consequences for hospitals and long-term care facilities (LTCFs). Design: Cross-sectional analyses of yearly hospital administrative data. Setting: All Belgian hospitals and discharge destinations, focusing on LTCFs. Participants: All individuals from the Brussels–Capital Region hospitalized for >1 day throughout Belgium between 2008 and 2020 (N = 1,915,572). Methods: We calculated HAI prevalences and then, adjusting for confounders, the odds of being discharged to a LTCF or being readmitted within 30 days postdischarge after an HAI. HAIs included hospital-associated bloodstream infections, hospital-associated urinary tract infections, hospital-associated pneumonia, ventilator-associated pneumonia, and surgical-site infections. Results: Between 2008 and 2020, we identified 77,004 HAIs. Changes in time trends occurred. We observed a decrease of all HAIs from 2012 to 2014 from 5.17% to 2.19% (P < .001) and an increase from 2019 to 2020 from 3.38% to 4.06% (P < .001). Among patients with HAIs, 24.36% were discharged to LTCFs and 13.51% underwent early readmission. For stays ≥4 days, HAIs were associated with higher odds of LTCF discharge (adjusted odds ratio [aOR], 1.25; 95% confidence interval [CI], 1.22–1.28), but with lesser odds of early readmission (aOR, 0.88; 95% CI, 0.85–0.90). Conclusions: Administrative data can be useful to detect HAIs trends, but they seem to underestimate the burden compared to surveillance systems. Risk factors of readmission should be identified during hospital stays to ensure continuity of care. Considering the results from 2020 coinciding with the COVID-19 pandemic, monitoring the impact of HAIs should continue.

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Improving hospital nurse staffing during the pandemic: Implementation of the 2019 Fund for Health Care Staff in Belgium

Cited by 10 publications

References 26 publications

Staffing, teamwork and scope of practice: Analysis of the association with patient safety in the context of rehabilitation

Staffing, teamwork and scope of practice: Analysis of the association with patient safety in the context of rehabilitation

COVID-19 Clusters in Belgian Nursing Homes: Impact of Facility Characteristics and Vaccination on Cluster Occurrence, Duration and Severity

Prevalence of hospital-associated infections and its association with discharge destinations and hospital readmissions in Brussels, Belgium, from 2008 to 2020: A hospital-based, cross-sectional study

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