Rosa-Zamboni Daniela de la, Carrasco-González Miroslava I, Blas-Barrientos Norma de, Flores-Constatino María L, Flores-Zamora Erika, Camacho-Pérez Martha, Neri-Saldaña Itzel G, Guerrero-Díaz Ana C
Subdirección de Atención Integral del Paciente.
Departamento de Enfermería.
Bol Med Hosp Infant Mex. 2023;80(1):29-35. doi: 10.24875/BMHIM.22000117.
Healthcare-associated infections (HCAIs) are a hospital problem with a prevalence of approximately 5% in Mexico. HCAIs have been related to the patient-nurse ratio (PNR). This study aimed to analyze the association between PNR and HCAI in a tertiary-level pediatric hospital.
We conducted a descriptive and prospective study at a tertiary-level pediatric hospital in Mexico. Nursing attendance and HCAIs records were documented from July 2017 to December 2018. PNR was calculated using nurse staffing records and patient census.
We obtained 63,114 staff attendance data from five hospital departments for the morning, evening, and night shifts. PNR > 2:1 was associated with a 54% (95% confidence interval (CI) 42-167%; p < 0.001) increased risk (odds ratio (OR)) for HCAIs, adjusted by shift staff, special conditions, and surveillance periods. The HCAIs more associated with PNR were urinary tract infections (OR 1.83; 95%CI 1.34-2.46), procedure-related pneumonia (OR 2.08; 95%CI 1.41-3.07), and varicella (OR 2.33; 95%CI 1.08-5.03).
A high number of patients per nurse increased the probability of various types of HCAI. PNR needs to be established the HCAI guidelines and policies, as regulating the number of patients per nurse can prevent HCAIs and their complications.
医疗保健相关感染（HCAIs）是一个医院问题，在墨西哥的患病率约为5%。HCAIs与患者护士比（PNR）有关。本研究旨在分析一家三级儿科医院中PNR与HCAI之间的关联。
我们在墨西哥一家三级儿科医院进行了一项描述性前瞻性研究。记录了2017年7月至2018年12月的护理出勤情况和HCAIs记录。使用护士人员配置记录和患者普查计算PNR。
我们从五个医院科室获取了63114条早班、晚班和夜班的工作人员出勤数据。经轮班工作人员、特殊情况和监测期调整后，PNR>2:1与HCAIs风险增加54%（95%置信区间（CI）42-167%；p<0.001）相关（优势比（OR））。与PNR关联度更高的HCAIs是尿路感染（OR 1.83；95%CI 1.34-2.46）、与操作相关的肺炎（OR 2.08；95%CI 1.41-3.07）和水痘（OR 2.33；95%CI 1.08-5.03）。
每名护士护理的患者数量过多会增加各类HCAI的发生概率。需要根据HCAI指南和政策确定PNR，因为规范每名护士护理的患者数量可以预防HCAIs及其并发症。
