Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2014.05.005
Brazilian Journal of Anesthesiology
Scientific Article

Bacterial colonization due to increased nurse workload in an intensive care unit

Colonização bacteriana por causa do aumento da carga de trabalho da equipe de enfermagem em unidade de terapia intensiva

Ilker Onguc Aycan; Mustafa Kemal Celen; Ayhan Yilmaz; Mehmet Selim Almaz; Tuba Dal; Yusuf Celik; Esef Bolat

http://dx.doi.org/10.1016/j.bjane.2014.05.005 Braz J Anesthesiol, vol.65, n3, p.180-185, 2015
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Abstract

INTRODUCTION: The rates of multiresistant bacteria colonization or infection (MRB+) development in intensive care units are very high. The aim of this study was to determine the possible association between the risk of development of nosocomial infections and increased daily nurse workload due to understaffing in intensive care unit. METHODS: We included 168 patients. Intensity of workload and applied procedures to patients were scored with the Project de Recherché en Nursing and the Omega scores, respectively. The criteria used for infections were those defined by the Centers for Disease Control. RESULTS: Of the 168 patients, 91 (54.2%) were female and 77 (45.8%) were male patients. The mean age of female and male was 64.9 ± 6.2 years and 63.1 ± 11.9 years, respectively. The mean duration of hospitalization in intensive care unit was 18.4 ± 6.1 days. Multiresistant bacteria were isolated from cultures of 39 (23.2%) patients. The development of MRB+ infection was correlated with length of stay, Omega 1, Omega 2, Omega 3, Total Omega, daily PRN, and Total PRN (p < 0.05). There was no correlation between development of MRB+ infection with gender, age and APACHE-II scores (p > 0.05). CONCLUSION: The risk of nosocomial infection development in an intensive care unit is directly correlated with increased nurse workload, applied intervention, and length of stay. Understaffing in the intensive care unit is an important health problem that especially affects care-needing patients. Nosocomial infection development has laid a heavy burden on the economy of many countries. To control nosocomial infection development in the intensive care unit, nurse workload, staffing level, and working conditions must be arranged.

Keywords

Understaffing, Workload, Nurse, Multiresistant bacteria

Resumo

INTRODUÇÃO: as taxas de desenvolvimento de infecção ou colonização por bactérias multirresistentes [BMR (+)] em unidades de terapia intensiva são muito elevadas. O objetivo deste estudo foi determinar a possível associação entre o risco de desenvolvimento de infecções hospitalares e o aumento da carga de trabalho diária da equipe de enfermagem por causa da insuficiência de pessoal em unidade de terapia intensiva. MÉTODOS: foram incluídos 168 pacientes. O volume da carga de trabalho e os procedimentos feitos em pacientes foram avaliados com o uso de instrumentos de medidas como o Projeto de Pesquisa em Enfermagem (Project de Recherché en Nursing) e o Omega, respectivamente. Os critérios usados para definir infecções foram os estabelecidos pelos Centros de Controle de Doenças. RESULTADOS: dos 168 pacientes, 91 (54,2%) eram do sexo feminino e 77 (45,8%) do masculino. As médias das idades de mulheres e homens foram 64,9 ± 6,2 e 63,1 ± 11,9 anos, respectivamente. A média do tempo de internação em unidade de terapia intensiva foi de 18,4 ± 6,1 dias. As bactérias multirresistentes foram isoladas a partir de culturas de 39 (23,2%) pacientes. O desenvolvimento de infecção por BMR (+) foi correlacionado com tempo de internação, Omega 1, Omega 2, Omega 3, Omega total, PPE diário e PPE total (p < 0,05). Não houve correlação entre desenvolvimento de infecção por BMR (+) e gênero, idade e escores no Apache-II (p > 0,05). CONCLUSÃO: o risco de desenvolvimento de infecção hospitalar em unidade de terapia intensiva está diretamente relacionado com o aumento da carga de trabalho de enfermagem, as intervenções praticadas e o tempo de internação. A falta de pessoal em unidade de terapia intensiva é um problema de saúde importante que afeta principalmente os pacientes que requerem cuidados. A infecção hospitalar colocou um fardo pesado sobre a economia de muitos países. Para controlar o desenvolvimento de infecção hospitalar em UTI, a carga de trabalho de enfermagem, a composição do pessoal e as condições de trabalho devem ser organizadas.

Palavras-chave

Falta de pessoal, Carga de trabalho, Enfermagem, Bactérias multirresistentes, Falta de pessoal, Carga de trabalho, Enfermagem, Bactérias multirresistentes

References

Garner JS. Hospital Infection Control Practices Advisory Committee. Guideline for isolation precautions in hospitals. Infect Control Hosp Epidemiol.. ;24:24-52.

Recommendations for preventing the spread of van- comycin resistance. Infect Control Hosp Epidemiol.. ;16:113-105.

Spengler RF, Greenough WB. Hospital costs and mortality attributed to nasocomial bacteremias. JAMA.. ;240:2455-2458.

Landry SL, Kaiser DL, Wenzel RP. Hospital stay and mortality attributed to noscomial enterococcal bacteremia: a controlled study. Am J Infect Control.. ;17:323-329.

Durand-Zaleski I. Estimating the cost of intensive care. Intensive Care Med.. ;20:539-538.

Coello R, Gleinster H, Fereres J. The cost of infec- tion in surgical patients: case-control study. J Hosp Infect.. ;25:250-239.

Kappstein I, Schulgen G, Beyer U. Prolongation of hospital stay and extra costs due to ventilator-associated pneumo- nia in an intensive care unit. Eur J Clin Microbiol Infect Dis.. ;11:504-508.

Saulnier F, Grandbastien B, Poisson C. Consequences de la multi-resistance bacterienne en Reanimation srla duree de sejour et la charge en soins. Rean Urg.. ;6:213-222.

Haley RW, Cushion NB, Tenover FC. Eradication of endemic methicilin-resistantStaphylococcus aureus infections from a neonatal intensive care unit. J Infect Dis.. ;171:614-624.

Score d'activité Oméga. Guide des Outils d'évaluation en Réanimation. :39-44.

Saulnier F, Duhammel A, Descamps JM. Indicateur simplifié de la chargeen soins spécifique a la réanimation: le PRN réa. Rean Urg.. ;4:569-559.

Taunton RL, Kleinbeck SVM, Stafford R. Patient outcomes. Are they linked to registered nurse absenteeism, separation, or workload?. J Nurs Adm.. ;24:54-48.

Saulnier F, Hubert H, Onimus T. Assessing excess nurse work load generated by multiresistant nasocomial bacteria in intensive care. Infect Control Hosp Epidemiol.. ;22:278-273.

Girou E, Stephan F, Novara A. Risk factors and outcome of nosocomial infections: results of a matched case-control study of ICU patients. Am J Respir Crit Care Med.. ;157:1151-1158.

Fridkin SK, Pear SM, Williamson TH. The role of under- staffing in central venous catheter-associated bloodstream infections. Infect Control Hosp Epidemiol.. ;17:150-158.

Pittet D, Touveneau S, Paccaud U. Infections acquises en reanimation et surcharge en soins. :301-304.

Robert J, Fridkin SK, Blumberg HM. The influence of the composition of the nursing staff on primary bloodstream infec- tion rates in a surgical intensive care unit. Infect Control Hosp Epidemiol.. ;21:12-17.

Stegenga J, Bell E, Matlow A. The role of nurse understaffing in nosocomial viral gastrointestinal infections on a general pedi- atrics ward. Infect Control Hosp Epidemiol.. ;23:133-136.

Hurst K. Relationships between patient dependency, nursing workload and quality. Int J Nurs Study.. ;42:75-84.

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