Impact of staffing on bloodstream infections in the neonatal intensive care unit.
OBJECTIVE
To examine the association between registered nurse staffing and healthcare-associated bloodstream infections in infants in the neonatal intensive care unit (NICU).


METHODS
Prospective cohort study.


METHODS
Two level III-IV NICUs in New York, NY, from March 1, 2001, through January 31, 2003.


METHODS
A total of 2675 infants admitted to the NICUs for more than 48 hours and all registered nurses who worked in the same NICUs during the study period. Intervention Hours of care provided by registered nurses. Main Outcome Measure Time to first episode of healthcare-associated bloodstream infection.


RESULTS
A total of 224 infants had an infection that met the study definition of healthcare-associated bloodstream infection. In a multivariate analysis, after controlling for infants' intrinsic and extrinsic risk factors, a greater number of hours of care provided by registered nurses in NICU 2 was associated with a decreased risk of bloodstream infection in these infants (hazard ratio, 0.21; 95% confidence interval, 0.06-0.79).


CONCLUSIONS
Our findings suggest that registered nurse staffing is associated with the risk of bloodstream infection in infants in the NICU.
Cimiotti
Jeannie P
JP
Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, 19104-6096, USA. jcimiott@nursing.upenn.edu
Haas
Janet
J
Saiman
Lisa
L
Larson
Elaine L
EL
D001724:Birth Weight; D002405:Catheterization, Central Venous; D015331:Cohort Studies; D003428:Cross Infection / Q000517:prevention & control*; D005260:Female; D006235:Hand Disinfection / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D015999:Multivariate Analysis; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000600:supply & distribution*; D010288:Parenteral Nutrition; D010561:Personnel Staffing and Scheduling; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology*; D016019:Survival Analysis; D000078329:Workforce