Clinical Nurse Specialist, Associate Professor, Department of Geriatrics, Aarhus University Hospital, Denmark.
Physician, Department of Geriatrics, Aarhus University Hospital, Denmark.
J Health Serv Res Policy. 2021 Oct;26(4):282-288. doi: 10.1177/1355819621994866. Epub 2021 Feb 14.
Patients accommodated in single-bed rooms may have a reduced risk of hospital-acquired infections (HAIs) compared to those in multi-bed rooms. This study aimed to examine the effect of single-bed accommodation on HAIs in older patients admitted to a geriatric ward.
A retrospective cohort study of patients admitted to geriatric wards in a university hospital in Central Denmark Region linked to a move to a newly built hospital, involving all consecutively admitted patients aged 65 years and over from 15 September to 19 December 2016 and a similar cohort admitted in the same three months in 2017. We compared the incidence of HAIs in patients in single-bed accommodation to those in multi-bed accommodation using retrospective review of electronic patient records, with all infections verified microbiologically or by X-ray with onset between 48 hours after admission to 48 hours after discharge from hospital.
In total 446 patients were included. The incidence of HAIs in multi-bed accommodation was 30% compared to 20% in single-bed accommodation. The hazard ratio was 0.62 (95% Confidence Interval 0.43-0.91, = 0.01) for single-bed accommodation. This finding remained robust after adjustment for age, sex, infection at admission, risk of sepsis, use of catheter, treatment with prednisone or methotrexate, and comorbidity index.
Accommodation in single-bed rooms appeared to reduce HAIs compared to multi-bed rooms in two geriatric wards. This finding should be considered as hypothesis-generating and be examined further using an experimental design.
与多人间相比,单人间可降低医院获得性感染(HAIs)的风险。本研究旨在探讨老年病房中单人间对 HAIs 的影响。
这是一项回顾性队列研究,纳入了丹麦中部地区一所大学医院老年病房中 2016 年 9 月 15 日至 12 月 19 日期间连续收治的所有年龄≥65 岁的患者,以及 2017 年同期类似队列中连续收治的患者。通过回顾电子病历,比较单人间和多人间患者的 HAIs 发生率,所有感染均通过微生物学或 X 射线检查确认,发病时间为入院后 48 小时至出院后 48 小时内。
共纳入 446 例患者。多人间 HAIs 的发生率为 30%,单人间为 20%。单人间的危险比为 0.62(95%置信区间为 0.43-0.91, = 0.01)。调整年龄、性别、入院时感染、脓毒症风险、导管使用、泼尼松或甲氨蝶呤治疗以及合并症指数后,这一发现仍然稳健。
与多人间相比,两间老年病房中单人间似乎可降低 HAIs。这一发现应被视为产生假说的依据,并进一步通过实验设计进行检验。