Use of Temporary Nursing Staff and Nosocomial Infections in Intensive Care Units, a Pilot Study

2.50
Hdl Handle:
http://hdl.handle.net/10755/335607
Category:
Abstract
Type:
Presentation
Title:
Use of Temporary Nursing Staff and Nosocomial Infections in Intensive Care Units, a Pilot Study
Author(s):
Bae, Sung-Heui
Lead Author STTI Affiliation:
Gamma Kappa
Author Details:
Sung-Heui Bae, PhD, MPH, RN, sbae@nursing.utexas.edu
Abstract:
Session presented on Sunday, July 27, 2014: Purpose: The use of this temporary nursing staff is controversial issues. Although hiring temporary nursing staff can help to increase staffing levels, it can also affect other nursing staff as well as care process, which leads to poorer patient care (Alonso-Echanove et al., 2003). Higher use of temporary staff can increase administrative burdens, disrupt routines and teamwork, and require additional supervision by permanent staff (Bae, Mark, & Fried, 2010). In a similar vein, empirical findings in this topic are also mixed. Some studies found that use of temporary nurses was related to the spread of nosocomial infection among patients (Alonso-Echanove et al., 2003), back injuries among nurses and patient falls (Bae et al., 2010). On the other hand, other studies found no relationships between the use of temporary nursing staff and quality indicators (Aiken, Shang, Xue, & Sloane, 2013; Xue, Aiken, Freund, & Noyes, 2012). Arguments behind this relationship are that temporary nursing staff are not less qualified than permanent staff (Aiken et al., 2013; Aiken, Xue, Clarke, & Sloane, 2007; Xue, Smith, Freund, & Aiken, 2012). An empirical study found that using temporary nursing staff were not related to poor quality of patient care, but poor work environments are the factor contributing to poor quality of care (Aiken et al., 2013; Xue, Aiken, et al., 2012). Although the intensive care units (ICU) are the work setting where temporary nursing staff spent most of their time, in the previous studies, researchers did not distinguish temporary and permanent nursing staff in their nurse staffing measures. Therefore, the purpose of the present study is to describe the nature and prevalence of the use of temporary nursing staff and to examine relationships between the use of temporary nursing staff and nosocomial infections in the ICUs. Methods: A secondary data analysis was conducted with data from the Western New York Center for Nursing Workforce and Quality. This data consisted of nursing unit level data on 14 ICU from 6 hospitals located in New York State. All data were collected monthly. A total of 144 ICU-month data points were used for the analysis sample. Nosocomial infections include central line associated blood stream infections (CLABSI), ventilator associated pneumonia (VAP), and total number of nosocomial infections combining those two. The use of temporary nursing staff was measured by nursing care hours per patient day provided by temporary nursing staff (in total & only by registered nurses). Also other nursing unit characteristics (nurse staffing, skill mix, unit size, and practice environment) were collected as control variables. Logistic regression models were used to examine the relationship between the temporary staffing and nosocomial infections. Results: The monthly means of CLABSI and VAP were 1.89 per 1,000 central line days and 2.18 per 1,000 ventilator days. In total, 2.73 nosocomial infections per 1,000 patient days occurred monthly. On average, 0.30 temporary nursing care hours per patient day were provided and 0.26 care hours by only temporary RNs. From the logistic regression models, we found that the use of temporary RN staff was not related to neither CLABSI nor VAP after controlling for other nursing unit characteristics. Conclusion: The findings of this pilot study suggests that the use of temporary nursing staff in ICUs was not related to nosocomial infections. As more temporary nursing staff are used to increase nurse staffing levels in ICUs, it is important to evaluate the impact of those temporary nurse staffing on patient outcomes. To make a conclusive decision about this relationship, future studies need to use a larger sample with other control variables which might affect both the use of temporary nursing staff and nosocomial infections.
Keywords:
Ventilator associated pneumonia; Temporary nursing staff; Central line associated blood stream infections
Repository Posting Date:
17-Nov-2014
Date of Publication:
17-Nov-2014
Conference Date:
2014
Conference Name:
25th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Hong Kong
Description:
International Nursing Research Congress, 2014 Theme: Engaging Colleagues: Improving Global Health Outcomes. Held at the Hong Kong Convention and Exhibition Centre, Wanchai, Hong Kong
Note:
This is an abstract-only submission. If the author has submitted a full-text item related to this abstract, you may find it by browsing the repository by author. If author contact information is availabe in this abstract, please feel free to contact him or her with your queries regarding this submission.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleUse of Temporary Nursing Staff and Nosocomial Infections in Intensive Care Units, a Pilot Studyen_GB
dc.contributor.authorBae, Sung-Heuien_GB
dc.contributor.departmentGamma Kappaen_GB
dc.author.detailsSung-Heui Bae, PhD, MPH, RN, sbae@nursing.utexas.eduen_GB
dc.identifier.urihttp://hdl.handle.net/10755/335607-
dc.description.abstractSession presented on Sunday, July 27, 2014: Purpose: The use of this temporary nursing staff is controversial issues. Although hiring temporary nursing staff can help to increase staffing levels, it can also affect other nursing staff as well as care process, which leads to poorer patient care (Alonso-Echanove et al., 2003). Higher use of temporary staff can increase administrative burdens, disrupt routines and teamwork, and require additional supervision by permanent staff (Bae, Mark, & Fried, 2010). In a similar vein, empirical findings in this topic are also mixed. Some studies found that use of temporary nurses was related to the spread of nosocomial infection among patients (Alonso-Echanove et al., 2003), back injuries among nurses and patient falls (Bae et al., 2010). On the other hand, other studies found no relationships between the use of temporary nursing staff and quality indicators (Aiken, Shang, Xue, & Sloane, 2013; Xue, Aiken, Freund, & Noyes, 2012). Arguments behind this relationship are that temporary nursing staff are not less qualified than permanent staff (Aiken et al., 2013; Aiken, Xue, Clarke, & Sloane, 2007; Xue, Smith, Freund, & Aiken, 2012). An empirical study found that using temporary nursing staff were not related to poor quality of patient care, but poor work environments are the factor contributing to poor quality of care (Aiken et al., 2013; Xue, Aiken, et al., 2012). Although the intensive care units (ICU) are the work setting where temporary nursing staff spent most of their time, in the previous studies, researchers did not distinguish temporary and permanent nursing staff in their nurse staffing measures. Therefore, the purpose of the present study is to describe the nature and prevalence of the use of temporary nursing staff and to examine relationships between the use of temporary nursing staff and nosocomial infections in the ICUs. Methods: A secondary data analysis was conducted with data from the Western New York Center for Nursing Workforce and Quality. This data consisted of nursing unit level data on 14 ICU from 6 hospitals located in New York State. All data were collected monthly. A total of 144 ICU-month data points were used for the analysis sample. Nosocomial infections include central line associated blood stream infections (CLABSI), ventilator associated pneumonia (VAP), and total number of nosocomial infections combining those two. The use of temporary nursing staff was measured by nursing care hours per patient day provided by temporary nursing staff (in total & only by registered nurses). Also other nursing unit characteristics (nurse staffing, skill mix, unit size, and practice environment) were collected as control variables. Logistic regression models were used to examine the relationship between the temporary staffing and nosocomial infections. Results: The monthly means of CLABSI and VAP were 1.89 per 1,000 central line days and 2.18 per 1,000 ventilator days. In total, 2.73 nosocomial infections per 1,000 patient days occurred monthly. On average, 0.30 temporary nursing care hours per patient day were provided and 0.26 care hours by only temporary RNs. From the logistic regression models, we found that the use of temporary RN staff was not related to neither CLABSI nor VAP after controlling for other nursing unit characteristics. Conclusion: The findings of this pilot study suggests that the use of temporary nursing staff in ICUs was not related to nosocomial infections. As more temporary nursing staff are used to increase nurse staffing levels in ICUs, it is important to evaluate the impact of those temporary nurse staffing on patient outcomes. To make a conclusive decision about this relationship, future studies need to use a larger sample with other control variables which might affect both the use of temporary nursing staff and nosocomial infections.en_GB
dc.subjectVentilator associated pneumoniaen_GB
dc.subjectTemporary nursing staffen_GB
dc.subjectCentral line associated blood stream infectionsen_GB
dc.date.available2014-11-17T13:55:45Z-
dc.date.issued2014-11-17-
dc.date.accessioned2014-11-17T13:55:45Z-
dc.conference.date2014en_GB
dc.conference.name25th International Nursing Research Congressen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationHong Kongen_GB
dc.descriptionInternational Nursing Research Congress, 2014 Theme: Engaging Colleagues: Improving Global Health Outcomes. Held at the Hong Kong Convention and Exhibition Centre, Wanchai, Hong Kongen_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item related to this abstract, you may find it by browsing the repository by author. If author contact information is availabe in this abstract, please feel free to contact him or her with your queries regarding this submission.en_GB
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