Hostname: page-component-8448b6f56d-42gr6 Total loading time: 0 Render date: 2024-04-23T09:26:01.026Z Has data issue: false hasContentIssue false
  • English
  • Français

The Role of Nurse Understaffing in Nosocomial Viral Gastrointestinal Infections on a General Pediatrics Ward

Published online by Cambridge University Press:  02 January 2015

Jacob Stegenga ,
Erica Bell  and
Anne Matlow
Jacob Stegenga
Affiliation:
Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
Erica Bell
Affiliation:
Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
Anne Matlow*
Affiliation:
Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada Department of Pediatric and Laboratory Medicine, The Hospital for Sick Children; and the Departments of Pediatrics and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
*
Infection Prevention and Control Program, The Hospital for Sick Children, 555 University Avenue, Toronto, M5G 1X8 Ontario, Canada
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To examine the relationship between nurse staffing levels and the rate of nosocomial viral gastrointestinal infections (NVGIs) in a general pediatrics population.

Design:

Retrospective descriptive study.

Setting:

A general pediatrics ward at The Hospital for Sick Children in Toronto, Ontario, Canada, a 320-bed, tertiary-care pediatric institution.

Results:

Forty-three NVGIs were detected in 37 patients of 2,929 admissions (1.3%). The monthly NVGI rate correlated significantly with the monthly night patient-to-nurse ratio (r = 0.56) and the monthly day patient-to-nurse ratio (r = 0.50). The nursing hours per patient-day during the preinfection period (PIP) were significantly lower than those during the nonpreinfection period (NPIP; 12.5 vs 13.0). There was no difference between the PIP and the NPIP day patient-to-nurse ratios (3.31 vs 3.32), but there was a significant difference between the PIP and the NPIP night patient-to-nurse ratios (3.26 vs 3.16). The incidence of NVGIs in the 72-hour period after any day when the nursing hours per patient-day were less than 10.5 was 6.39 infections per 1,000 patient-days, compared with 2.17 infections per 1,000 patient-days in periods with more than 10.5 nursing hours per patient-day (rate ratio, 2.94; 95% confidence interval, 2.16 to 4.01).

Conclusion:

Nurse understaffing contributed to an increased NVGI rate in our general pediatrics population, and should be assessed as a risk factor in outbreak investigations.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 23 , Issue 3 , March 2002 , pp. 133 - 136
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Haley, RW, Bregman, DA. The role of understaffing and overcrowding in recurrent outbreaks of staphylococcal infection in a neonatal special-care unit. J Infect Dis 1982;145:875–885.CrossRefGoogle Scholar
2.Heseltine, P. Too many or too few hands? Infect Control Hosp Epidemiol 1999;20:595–597.Google ScholarPubMed
3.Duncan, RA, Levine, A, Willey, S, et al. Nursing staffing and central venous catheter-related bloodstream infections (CVC-BSIs) in a changing surgical intensive care unit (SICU). Presented at the Ninth Annual Meeting of the Society for Healthcare Epidemiology of America; April 18-20,1999; San Francisco, CA Abstract.Google Scholar
4.Fridkin, SK, Pear, SM, Williamson, TH, Galgiani, JN, Jarvis, WR. The role of understaffing in central venous catheter-associated bloodstream infections. Infect Control Hosp Epidemiol 1996;17:150–158.Google ScholarPubMed
5.Archibald, LK, Manning, ML, Bell, LM, Banerjee, S, Jarvis, WR. Patient density, nurse-to-patient ratio and nosocomial infection risk in a pediatric cardiac intensive care unit. Pediatr Infect Dis J 1997;16:1045–1048.CrossRefGoogle Scholar
6.Kovner, C, Gergen, PJ. Nurse staffing levels and adverse events following surgery in U.S. hospitals. Image J Nurs Sch 1998;30:315–321.Google Scholar
7.Harbarth, S, Sudre, P, Dharan, S, Cadenas, M, Pittet, D. Outbreak of Enterobacter cloacae related to understaffing, overcrowding and poor hygiene practices. Infect Control Hosp Epidemiol 1999;20:598–603.Google Scholar
8.Loeb, M, Salama, S, Armstrong-Evans, M, et al. Nursing workload was not an independent risk factor for nosocomial colonization with VRE. Presented at the Ninth Annual Meeting of the Society for Healthcare Epidemiology of America; April 18-20,1999; San Francisco, CA Abstract 3.Google ScholarPubMed
9.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128–140.CrossRefGoogle ScholarPubMed
10.Rosner, BA. Fundamentals of Biostatistics, 4th ed. Scarborough, Ontario, Canada: Wadsworth Publishing; 1995:592–597.Google Scholar
11.Albert, RF, Condie, F. Handwashing patterns in medical intensive-care units. N Engl J Med 1981;304:1465–1466.CrossRefGoogle ScholarPubMed
12.Larson, E. Compliance with isolation techniques. Am J Infect Control 1981;11:221–225.CrossRefGoogle Scholar
13.Pittet, D, Mourouga, P, Perneger, TV. Compliance with handwashing in a teaching hospital: infection control program. Ann Intern Med 1999; 130:126–130.CrossRefGoogle Scholar
14.Preston, GA, Larson, EL, Stamm, WE. The effect of private isolation rooms on patient care practices, colonization and infection in an intensive care unit. Am J Med 1981;70:641–645.CrossRefGoogle Scholar
15.Haley, RW, Cushion, NB, Tenover, FC, et al. Eradication of endemic methicillin-resistant Staphylococcus aureus infections from a neonatal intensive care unit. J Infect Dis 1995;171:614–624.CrossRefGoogle ScholarPubMed
16.Trundle, CM, Farrington, M, Anderson, L, Redpath, CK. GRASPing infection: a workload measurement tool for infection control nurses. J Hosp Infect 2001;49:215–221.CrossRefGoogle ScholarPubMed