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Ratio of nursing staff to patients with infection control precautions

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  • #72244
    Anonymous
    Inactive

    Author:
    Anonymous

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    Dear ICPs,
    I am seeking your advice or any information/research/journal article/documentation you might have when considering the staffing ratio of nurse to patients with infection control precautions. For example,
    In our new hospital our wards have 12 single rooms. If all these rooms were to be occupied by patients who needed to be managed with transmission based precautions, does this mean that there is a need to increase the number of nurses to patients to cope with the additional requirements that are needed when caring for these patients (e.g., donning and doffing PPE , comorbidities,). Obviously I feel that there is a risk of having transmission as staff who are already burdened may not be able to strictly adhere to the Infection control recommendations for caring for these patients. Do you have any such rule in place or how do you manage if this occurs in your hospitals?
    Many thanks in advance,
    Rita

    Rita Roy

    Clinical Nurse Consultant | Infection Control
    Hornsby Ku ring gai Health Service, Palmerston Road, Hornsby NSW 2076
    Tel (02) 9477 9232 | Fax (02) 9477 9013 Rita.Roy@health.nsw.gov.au
    http://www.health.nsw.gov.au

    Click here to visit the Infection Prevention and Control page on the Intranet
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    #72248
    Kevin Kavanagh
    Participant

    Author:
    Kevin Kavanagh

    Email:
    kavanagh.ent@GMAIL.COM

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    The California Nurses Association, and the associated National Nurses
    United in the U.S. has done the extensive work on Staffing Ratios. Linda
    Akens also has been quite active in the field of research. Most of the
    below will contain references to articles dealing with infections.

    A very good reference is:

    Cimiotti JP, Aiken LH, Sloane DM, Wu ES. Nurse staffing, burnout, and
    health care-associated infection. Am J Infect Control. 2012
    Sep;40(7):680 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3509207/
    News release:
    http://www.eurekalert.org/pub_releases/2012-07/afpi-nsb072612.php

    Other related references are:

    Aiken, L. H., Cimiotti, J. P., Sloane, D. M., Smith, H. L., Flynn, L., &
    Neff, D. F. (2011). Effects of nurse staffing and nurse education on
    patient deaths in hospitals with different nurse work environments. *Medical
    Care*, *49*(12), 1047-1053.

    Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., & Silber, J. H.
    (2002). Hospital nurse staffing and patient mortality, nurse burnout, and
    job dissatisfaction. *Journal of the American Medical Association*, *288*(16),
    1987-1993.

    Aiken, L. H., Sloane, D. M., Cimiotti, J. P., Clarke, S. P., Flynn, L.,
    Seago, J. A., Spetz, J., & Smith, H. L. (2010). Implications of the
    California nurse staffing mandate for other states. *Health Services
    Research, 45*(4), 904-921.

    Needleman, J., Buerhaus, P., Mattke, S., Stewart, M., & Zelevinsky, K.
    (2002). Nurse-staffing levels and the quality of care in hospitals. *New
    England Journal of Medicine, 346*(22), 1715-1722.

    Needleman, J., Buerhaus, P., Pankratz, V. S., Leibson, C. L., Stevens, S.
    R., & Harris, M. (2011). Nurse staffing and inpatient hospital mortality. *New
    England Journal of Medicine, 364*(11), 1037-1045.

    Needleman, J., Buerhaus, P. I., Stewart, M., Zelevinsky, K., & Mattke, S.
    (2006) Nurse staffing in hospitals: is there a business case for
    quality? *Health
    Affairs (Millwood), 25*(1), 204-211.

    Stanton, M. W., & Rutherford M. (2004). *Hospital nurse staffing and
    quality of care*. Rockville, MD: Agency for Healthcare Research and
    Quality. http://archive.ahrq.gov/research/findings/factsheets/services/nursestaffing/nursestaff.pdf

    Kevin T. Kavanagh, MD, MS
    Health Watch USA
    Lexington, KY
    606-875-3642

    On Mon, Jul 6, 2015 at 2:03 AM, Rita Roy wrote:

    > Dear ICPs,
    >
    > I am seeking your advice or any information/research/journal
    > article/documentation you might have when considering the staffing ratio of
    > nurse to patients with infection control precautions. For example,
    >
    > In our new hospital our wards have 12 single rooms. If all these rooms
    > were to be occupied by patients who needed to be managed with transmission
    > based precautions, does this mean that there is a need to increase the
    > number of nurses to patients to cope with the additional requirements that
    > are needed when caring for these patients (e.g., donning and doffing PPE ,
    > comorbidities,). Obviously I feel that there is a risk of having
    > transmission as staff who are already burdened may not be able to strictly
    > adhere to the Infection control recommendations for caring for these
    > patients. Do you have any such rule in place or how do you manage if this
    > occurs in your hospitals?
    >
    > Many thanks in advance,
    >
    > Rita
    >
    >
    >
    > *Rita Roy*
    >
    > Clinical Nurse Consultant | *Infection Control*
    >
    > Hornsby Ku ring gai Health Service, Palmerston Road, Hornsby NSW 2076
    > Tel (02) 9477 9232 | Fax (02) 9477 9013 Rita.Roy@health.nsw.gov.au
    > http://www.health.nsw.gov.au
    >
    >
    >
    > Click here to visit the Infection Prevention and Control
    >
    > page on the Intranet
    >
    > [image: Description: Description:
    > http://internal.health.nsw.gov.au/communications/e-signatures/images/NSW-Health-Northern-Sydney-LHD.jpg%5D
    >
    >
    >
    > [image: Description: 5 moments hand hygiene]
    >
    >
    >
    > This message is intended for the addressee named and may contain
    > confidential information. If you are not the intended recipient, please
    > delete it and notify the sender.
    >
    > Views expressed in this message are those of the individual sender, and
    > are not necessarily the views of NSW Health or any of its entities.
    > MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO
    > NOT REPRESENT THE OPINION OF ACIPC.
    >
    > The use of trade/product/commercial brand names through the list is
    > discouraged by ACIPC. If you wish to discuss specific reference to products
    > or services by brand or commercial names, please do this outside the list.
    >
    > Archive of all messages are available at http://aicalist.org.au/archives
    > – registration and login required.
    >
    > Replies to this message will be directed back to the list. To create a new
    > message send an email to aicalist@aicalist.org.au
    >
    > To send a message to the list administrator send an email to
    > aicalist-request@aicalist.org.au.
    >
    > You can unsubscribe from this list be sending ‘signoff aicalist’ (without
    > the quotes) to listserv@aicalist.org.au
    >


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