Work hours, work stress, and collaboration among ward staff in relation to risk of hospital-associated infection among patients.
OBJECTIVE
To examine the association between work hours, work stress, and collaboration among the ward personnel, and the risk of hospital-associated infection among patients.


METHODS
Cross-sectional data on hospital infections were collected between March and June 2004. These data were linked with ward-level responses to a personnel survey collected during the same time period.


METHODS
Medical records of patients in 60 non-psychiatric bed wards in 6 Finnish hospitals.


METHODS
One thousand ninety-two patients and 1159 staff survey responses.


METHODS
Prevalence surveillance was performed by 4 infection control nurses, using standard criteria. Data on several potential risk factors for infection were collected: sex, age, patient type (surgical vs. other), hospital type (university vs. regional hospital), unit type, number of patients in the ward, exposure to invasive devices, International Classification of Diseases version 10 diagnosis, chemotherapy, radiotherapy, and use of corticosteroids. Staff working conditions were measured by survey scales.


RESULTS
Ninety-nine cases (9.1%) of hospital-associated infection were found. Multilevel logistic regression analyses, adjusted for hospital factors and patient-related risk factors, showed that long work hours among staff were associated with increased risk of infection [odds ratio (OR) 2.74, 95% confidence interval (CI): 1.07-7.04]. Other staff-related correlates of infection were high work stress, as indicated by high imbalance between efforts and rewards (OR: 2.47; 95% CI: 1.38-4.42), low trust between work unit members (OR: 2.37; 95% CI: 1.27-4.43), injustice in the distribution of work (OR: 1.81; 95% CI: 1.04-3.16), and poor collaboration between ward supervisors (OR: 2.46; 95% CI: 1.38-4.38).


CONCLUSIONS
Long work hours, high work stress, and poor collaboration among the ward staff are associated with hospital-associated infection among patients.
Virtanen
Marianna
M
Finnish Institute of Occupational Health, Work and Organizations, Helsinki, Finland. marianna.virtanen@ttl.fi
Kurvinen
Tiina
T
Terho
Kirsi
K
Oksanen
Tuula
T
Peltonen
Reijo
R
Vahtera
Jussi
J
Routamaa
Marianne
M
Elovainio
Marko
M
Kivimäki
Mika
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002055:Burnout, Professional / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003299:Cooperative Behavior; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006757:Hospital Units / Q000145:classification / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D015279:Organizational Culture; D010348:Patient Care Team; D010561:Personnel Staffing and Scheduling; D010564:Personnel, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D018571:Sentinel Surveillance; D035502:Trust; D014940:Work Schedule Tolerance; D016526:Workload / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult