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护士排班重组可降低医源性感染风险。

Reorganization of nurse scheduling reduces the risk of healthcare associated infections.

机构信息

INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, 27 rue Chaligny, 75012, Paris, France.

Tokyo Tech World Research Hub Initiative, Institute of Innovative Research, Tokyo Institute of Technology, Tokyo, Japan.

出版信息

Sci Rep. 2021 Apr 1;11(1):7393. doi: 10.1038/s41598-021-86637-w.

Abstract

Efficient prevention and control of healthcare associated infections (HAIs) is still an open problem. Using contact data from wearable sensors at a short-stay geriatric ward, we propose a proof-of-concept modeling study that reorganizes nurse schedules for efficient infection control. This strategy switches and reassigns nurses' tasks through the optimization of shift timelines, while respecting feasibility constraints and satisfying patient-care requirements. Through a Susceptible-Colonized-Susceptible transmission model, we found that schedules reorganization reduced HAI risk by 27% (95% confidence interval [24, 29]%) while preserving timeliness, number, and duration of contacts. More than 30% nurse-nurse contacts should be avoided to achieve an equivalent reduction through simple contact removal. Nurse scheduling can be reorganized to break potential chains of transmission and substantially limit HAI risk, while ensuring the timeliness and quality of healthcare services. This calls for including optimization of nurse scheduling practices in programs for infection control in hospitals.

摘要

高效预防和控制医疗保健相关感染(HAIs)仍然是一个悬而未决的问题。利用短期老年病房可穿戴传感器的接触数据,我们提出了一项概念验证模型研究,通过优化轮班时间表来重新安排护士的工作,以实现有效的感染控制。该策略通过优化轮班时间表来切换和重新分配护士的任务,同时尊重可行性约束和满足患者护理需求。通过易感性-感染-易感性传播模型,我们发现,时间表的重新安排将 HAI 风险降低了 27%(95%置信区间[24, 29]%),同时保持了及时性、接触次数和接触时间。通过简单地去除接触,应该避免超过 30%的护士-护士接触,以达到同等的降低效果。可以重新安排护士的排班,以打破潜在的传播链,并大大限制 HAI 风险,同时确保医疗保健服务的及时性和质量。这就需要将护士排班的优化纳入医院感染控制计划中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b8d/8016903/54c8b6fda244/41598_2021_86637_Fig1_HTML.jpg

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