Department of Neonatal Intensive Care, Division of Paediatric and Adolescent Medicine, Stavanger University Hospital, Stavanger, Norway.
Lovisenberg Diaconal University College, Oslo, Norway.
Acta Paediatr. 2022 Nov;111(11):2090-2097. doi: 10.1111/apa.16494. Epub 2022 Aug 2.
To study whether overcrowding and/or nurse understaffing preceded four bacterial outbreaks during a 5-year period in a Norwegian university hospital neonatal intensive care unit (NICU).
A repeated cross-sectional study based on prospectively collected data from the Norwegian neonatal network's (NNN) web-based electronic database, digital work schedules and information about the outbreaks from logs, reports and publications. Number of admitted patients, category 4-5 patients (i.e., with the highest nurse to patient ratio), rostered nursing staff and nurse specialists were analysed in relation to periods (1) >28 days before individual outbreaks, (2) ≤28 days before, (3) during and (4) after outbreaks. Overcrowding and understaffing were compared between the four periods with Chi-square test and post hoc analysis with Bonferroni correction.
When all outbreaks were analysed together, overcrowding was more frequent in the periods within 28 days of outbreaks compared to the other periods (p < 0.001). For understaffing, the periods within 28 days of outbreaks were only different from the periods >28 days before outbreaks (p < 0.001). The trends regarding individual outbreaks were less consistent, but there were more category 4-5 patients before and during the outbreaks.
Bacterial outbreaks in a 5-year period were weakly associated with overcrowding and understaffing.
研究在挪威大学医院新生儿重症监护病房（NICU）的 5 年期间，是否有过度拥挤和/或护士人手不足导致了 4 次细菌爆发。
这是一项基于挪威新生儿网络（NNN）的基于网络的电子数据库、数字工作计划以及日志、报告和出版物中有关爆发的信息的前瞻性收集数据的重复横断面研究。根据（1）个别爆发前>28 天，（2）≤28 天前，（3）爆发期间和（4）爆发后，分析住院患者人数、第 4-5 类患者（即，护士与患者比例最高）、在册护理人员和护士专家的人数。使用卡方检验和 Bonferroni 校正的事后分析比较了四个时期的过度拥挤和人手不足情况。
当所有爆发一起分析时，与其他时期相比，爆发前 28 天内的过度拥挤更为频繁（p<0.001）。对于人手不足，只有在爆发前 28 天的时期与其他时期不同（p<0.001）。个别爆发的趋势不太一致，但在爆发前和爆发期间有更多的第 4-5 类患者。
5 年内的细菌爆发与过度拥挤和人手不足有一定的关联。
