Healthcare-associated infections in adult intensive care units: A multisource study examining nurses' safety attitudes, quality of care, missed care, and nurse staffing.

Alanazi, FK; Lapkin, S; Molloy, L; Sim, J

Healthcare-associated infections in adult intensive care units: A multisource study examining nurses' safety attitudes, quality of care, missed care, and nurse staffing.

Alanazi, FK Lapkin, S Molloy, L Sim, J

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Publisher:: ELSEVIER SCI LTD
Publication Type:: Journal Article
Citation:: Intensive Crit Care Nurs, 2023, 78, pp. 103480
Issue Date:: 2023-10

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Field	Value	Language
dc.contributor.author	Alanazi, FK
dc.contributor.author	Lapkin, S
dc.contributor.author	Molloy, L
dc.contributor.author	Sim, J https://orcid.org/0000-0001-6863-0541
dc.date.accessioned	2023-11-06T22:24:52Z
dc.date.available	2023-06-08
dc.date.available	2023-11-06T22:24:52Z
dc.date.issued	2023-10
dc.identifier.citation	Intensive Crit Care Nurs, 2023, 78, pp. 103480
dc.identifier.issn	0964-3397
dc.identifier.issn	1532-4036
dc.identifier.uri	http://hdl.handle.net/10453/173088
dc.description.abstract	OBJECTIVES: This study examined the association between safety attitudes, quality of care, missed care, nurse staffing levels, and the rate of healthcare-associated infection (HAI) in adult intensive care units (ICUs). METHODS: A cross-sectional study was conducted in five hospitals. Nurses completed a validated survey on safety attitudes, quality of care, missed care, nurse staffing levels, and the frequency of HAIs. Secondary data were collected on the incidence of central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI), and ventilator-associated pneumonia (VAP) in participating units. Descriptive analysis and generalized linear models were performed. RESULTS: A total of 314 nurses from eight ICUs participated in this study. The mean safety culture score was 60.85 (SD = 3.53). ICUs with strong job satisfaction had lower incidence and nurse-reported frequency of CLABSI, CAUTI, and VAP. Missed care was common, with 73.11% of nurses reporting missing at least one required care activity on their last shift. The mean patient-to-nurse ratio was 1.95. Increased missed care and higher workload were associated with higher HAIs. Nurses' perceptions of CLABSI and VAP frequency were positively associated with the actual occurrence of CLABSI and VAP in participating units. CONCLUSION: Positive safety culture and better nurse staffing levels can lower the rates of HAIs in ICUs. Improvements to nurse staffing will reduce nursing workloads, which may reduce missed care, increase job satisfaction, and, ultimately, reduce HAIs. IMPLICATIONS FOR CLINICAL PRACTICE: Higher levels of job satisfaction among ICU nurses, lower proportions of missed nursing care and higher nurse staffing are associated with lower rates of HAIs. Nurse-reported HAI frequency was positively associated with the incidence of HAIs; therefore, nurses provide reliable data on infection control outcomes in ICU settings.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	ELSEVIER SCI LTD
dc.relation.ispartof	Intensive Crit Care Nurs
dc.relation.isbasedon	10.1016/j.iccn.2023.103480
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1110 Nursing
dc.subject.classification	Nursing
dc.subject.classification	4205 Nursing
dc.subject.mesh	Adult
dc.subject.mesh	Humans
dc.subject.mesh	Catheter-Related Infections
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Cross Infection
dc.subject.mesh	Intensive Care Units
dc.subject.mesh	Pneumonia, Ventilator-Associated
dc.subject.mesh	Urinary Tract Infections
dc.subject.mesh	Attitude
dc.subject.mesh	Delivery of Health Care
dc.subject.mesh	Nurses
dc.subject.mesh	Humans
dc.subject.mesh	Cross Infection
dc.subject.mesh	Urinary Tract Infections
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Attitude
dc.subject.mesh	Adult
dc.subject.mesh	Nurses
dc.subject.mesh	Intensive Care Units
dc.subject.mesh	Delivery of Health Care
dc.subject.mesh	Pneumonia, Ventilator-Associated
dc.subject.mesh	Catheter-Related Infections
dc.subject.mesh	Adult
dc.subject.mesh	Humans
dc.subject.mesh	Catheter-Related Infections
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Cross Infection
dc.subject.mesh	Intensive Care Units
dc.subject.mesh	Pneumonia, Ventilator-Associated
dc.subject.mesh	Urinary Tract Infections
dc.subject.mesh	Attitude
dc.subject.mesh	Delivery of Health Care
dc.subject.mesh	Nurses
dc.title	Healthcare-associated infections in adult intensive care units: A multisource study examining nurses' safety attitudes, quality of care, missed care, and nurse staffing.
dc.type	Journal Article
utslib.citation.volume	78
utslib.location.activity	Netherlands
utslib.for	1110 Nursing
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/WHO Collaborating Centre
utslib.copyright.status	closed_access	*
dc.date.updated	2023-11-06T22:24:51Z
pubs.publication-status	Published
pubs.volume	78

Abstract:

OBJECTIVES: This study examined the association between safety attitudes, quality of care, missed care, nurse staffing levels, and the rate of healthcare-associated infection (HAI) in adult intensive care units (ICUs). METHODS: A cross-sectional study was conducted in five hospitals. Nurses completed a validated survey on safety attitudes, quality of care, missed care, nurse staffing levels, and the frequency of HAIs. Secondary data were collected on the incidence of central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI), and ventilator-associated pneumonia (VAP) in participating units. Descriptive analysis and generalized linear models were performed. RESULTS: A total of 314 nurses from eight ICUs participated in this study. The mean safety culture score was 60.85 (SD = 3.53). ICUs with strong job satisfaction had lower incidence and nurse-reported frequency of CLABSI, CAUTI, and VAP. Missed care was common, with 73.11% of nurses reporting missing at least one required care activity on their last shift. The mean patient-to-nurse ratio was 1.95. Increased missed care and higher workload were associated with higher HAIs. Nurses' perceptions of CLABSI and VAP frequency were positively associated with the actual occurrence of CLABSI and VAP in participating units. CONCLUSION: Positive safety culture and better nurse staffing levels can lower the rates of HAIs in ICUs. Improvements to nurse staffing will reduce nursing workloads, which may reduce missed care, increase job satisfaction, and, ultimately, reduce HAIs. IMPLICATIONS FOR CLINICAL PRACTICE: Higher levels of job satisfaction among ICU nurses, lower proportions of missed nursing care and higher nurse staffing are associated with lower rates of HAIs. Nurse-reported HAI frequency was positively associated with the incidence of HAIs; therefore, nurses provide reliable data on infection control outcomes in ICU settings.

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http://hdl.handle.net/10453/173088