Shang Jingjing, Needleman Jack, Liu Jianfang, Larson Elaine, Stone Patricia W
Author Affiliations: Associate Professor (Dr Shang), Assistant Professor of Quantitative Research (Dr Liu), Professor and Associate Dean for Research (Dr Larson), Professor and Director of Center for Health Policy (Dr Stone), School of Nursing, Columbia University, New York; and Professor and Chair (Dr. Needleman), Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California.
J Nurs Adm. 2019 May;49(5):260-265. doi: 10.1097/NNA.0000000000000748.
To examine whether healthcare-associated infections (HAIs) and nurse staffing are associated using unit-level staffing data.
Previous studies of the association between HAIs and nurse staffing are inconsistent and limited by methodological weaknesses.
Cross-sectional data between 2007 and 2012 from a large urban hospital system were analyzed. HAIs were diagnosed using the Centers for Disease Control and Prevention's National Healthcare Safety Network definitions. We used Cox proportional-hazards regression model to examine the association of nurse staffing (2 days before HAI onset) with HAIs after adjusting for individual risks.
Fifteen percent of patient-days had 1 shift understaffed, defined as staffing below 80% of the unit median for a shift, and 6.2% had both day and night shifts understaffed. Patients on units with both shifts understaffed were significantly more likely to develop HAIs 2 days later.
Understaffing is associated with increased risk of HAIs.
使用科室层面的人员配置数据，研究医疗保健相关感染（HAIs）与护士人员配置之间是否存在关联。
先前关于HAIs与护士人员配置之间关联的研究结果不一致，且存在方法学上的缺陷。
分析了2007年至2012年来自一个大型城市医院系统的横断面数据。HAIs根据疾病控制和预防中心的国家医疗安全网络定义进行诊断。我们使用Cox比例风险回归模型，在调整个体风险后，研究护士人员配置（HAI发病前2天）与HAIs之间的关联。
15%的患者日有1个班次人员配备不足，即人员配备低于科室该班次中位数的80%，6.2%的患者日白班和夜班均人员配备不足。两个班次均人员配备不足的科室的患者在2天后发生HAIs的可能性显著更高。
人员配备不足与HAIs风险增加有关。
