Colonización bacteriana debido al aumento de la carga de trabajo del equipo de enfermería en una unidad de cuidados intensivos

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

Introduction

The rates of multiresistant bacteria colonization or infection 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 multiresistant bacteria colonization infection was correlated with length of stay, Omega 1, Omega 2, Omega 3, total Omega, daily PRN, and total PRN (P < .05). There was no correlation between development of multiresistant bacteria colonization infection with gender, age and APACHE-II scores (P > .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.

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在重症监护病房,由于护理人员工作量增加而导致的细菌定植
重症监护病房多重耐药细菌定植或感染发展的比率非常高。本研究的目的是确定医院感染发生的风险与由于重症监护室人手不足而增加的日常护士工作量之间可能存在的关联。方法纳入168例患者。患者的工作量强度和应用程序分别用Project de recherch护理和Omega评分进行评分。感染的标准由疾病控制中心定义。结果168例患者中,女性91例(54.2%),男性77例(45.8%)。女性平均年龄为64.9±6.2岁,男性平均年龄为63.1±11.9岁。重症监护病房平均住院时间为18.4±6.1天。从39例(23.2%)患者的培养物中分离出多重耐药菌。多耐药菌定植感染的发生与住院时间、欧米伽1、欧米伽2、欧米伽3、总欧米伽、每日PRN和总PRN相关(P <. 05)。多耐药菌定植感染的发生与性别、年龄和APACHE-II评分无相关性(P >. 05)。结论重症监护病房发生院内感染的风险与护士工作量增加、采取干预措施和住院时间长短直接相关。重症监护室人员不足是一个重要的健康问题,尤其影响到需要护理的病人。医院感染的发展给许多国家的经济带来了沉重的负担。为了控制重症监护室院内感染的发展,必须安排护士的工作量、人员配备水平和工作条件。
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