College of Nursing & The Research Institute of Nursing Science, Daegu Catholic University, Daegu, Korea (Dr Y. J. Lee); College of Nursing & Mo-Im Kim Nursing Research Institute (Drs T. L. Lee and Cho) and Graduate School of Public Health & Institute of Health Services Research (Dr S. Park), Yonsei University, Seoul, Korea; and Quality Assessment Department, Health Insurance Review & Assessment Service, Wonju, Korea (Dr C. S. Park).
J Perinat Neonatal Nurs. 2020 Apr/Jun;34(2):E12-E18. doi: 10.1097/JPN.0000000000000475.
Prior studies have reported inconsistent findings regarding the relationship between nurse staffing and nosocomial infections in very low-birth-weight (VLBW) infants. Little is known about whether similar associations occur in Korea. The purpose of this study was to identify the nurse staffing of neonatal intensive care units (NICUs) in Korea and to verify the association between nurse staffing and nosocomial infections among VLBW infants in NICUs. We selected 4654 VLBW infants admitted to 52 hospitals. Nosocomial infections were defined as incidence of bloodstream infection, urinary tract infection (UTI), or rotavirus infection. The average number of NICU patients per nurse was 4.51(minimum-maximum: 2.38-8.16). Hospitals with a higher number of patients per nurse exhibited a significant increased UTI rate (P = .005) and rotavirus infection rate (P = .025) in the univariate analysis. After adjusting for all patient and hospital characteristics, UTI significantly increased with increasing number of patients per nurse (odds ratio [OR] = 1.79; 95% confidence interval, 1.29-2.47), while bloodstream infection (OR = 0.93; 95% confidence interval, 0.79-1.09) and rotavirus infection (OR = 1.14; 95% confidence interval, 0.92-1.41) were not significant. These findings revealed that a nurse staffing in NICUs is an important factor for preventing UTI among VLBW infants.
先前的研究报告称，护士人数与极低出生体重（VLBW）婴儿医院感染之间的关系存在不一致的结果。关于这种关联是否也存在于韩国，知之甚少。本研究的目的是确定韩国新生儿重症监护病房（NICU）的护士人数，并验证 NICU 中护士人数与 VLBW 婴儿医院感染之间的关系。我们选择了 52 家医院的 4654 名 VLBW 婴儿。医院感染定义为血流感染、尿路感染（UTI）或轮状病毒感染的发生率。每名护士平均照顾的 NICU 患者为 4.51（最小值-最大值：2.38-8.16）。在单因素分析中，护士人数与患者人数比值较高的医院 UTI 发生率（P =.005）和轮状病毒感染率（P =.025）显著升高。在调整了所有患者和医院特征后，随着护士人数与患者人数比值的增加，UTI 显著增加（比值比 [OR] = 1.79；95%置信区间，1.29-2.47），而血流感染（OR = 0.93；95%置信区间，0.79-1.09）和轮状病毒感染（OR = 1.14；95%置信区间，0.92-1.41）则不显著。这些发现表明，NICU 的护士人数是预防 VLBW 婴儿 UTI 的一个重要因素。
