Nursing sensitive outcomes and staffing: A review on healthcare associated infection

Nursing sensitive outcomes and staffing: a review on healthcare associated infection. Introduction. Healthcare associated infections (HAI) continue to be an unresolved problem in hospital settings. Aim. To assess the relationship between nurse staffing and healthcare associated infections in different settings. Methods. From April to May 2015 a review of literature was conducted consulting PubMed, CINAHL and Cochrane Library. Results. An increased amount of Registered Nurse Hours Per Patient Day (RNHPPD) and nurse-to-patient ratio was associated to a decreased occurrence of HAI. In particular an increase of RNHPPD was associated to a reduction of postoperative (OR 0.83, IC95% 0.0.70-0.99), and ventilator-associated pneumonia (OR 0.21, IC95% 0.08-0.53). Even the number of urinary tract infections (-34%) and sepsis (OR 0.54, IC95%: 0.31-0.92) decreased significantly. The most significant results associated to an increase of HPPD were obtained in intensive care units. Conclusions. The review showed the correlations between nurse staffing and the most frequent HAIs. Nursing managers should be aware of the adequate nurse-to-patient ratios and skill-mix in order to inform decision making and improve the quality and safety of patients care.