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Association between nurse staffing level in intensive care settings and hospital-acquired pneumonia among surgery patients: result from the Korea National Health Insurance cohort

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dc.contributor.author박은철-
dc.contributor.author장석용-
dc.contributor.author장성인-
dc.date.accessioned2024-06-14T02:52:31Z-
dc.date.available2024-06-14T02:52:31Z-
dc.date.issued2024-02-
dc.identifier.issn0950-2688-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/199746-
dc.description.abstractThis study examined the association between the number of nursing staff in intensive care units (ICUs) and hospital-acquired pneumonia (HAP) among surgical patients in South Korea. Data were obtained between 2008 and 2019 from the Korean National Health Insurance Service Cohort Database; 37,706 surgical patients who received critical care services were included in the analysis. Patients with a history of pneumonia 1 year prior to surgery or those who had undergone lung-related surgery were excluded. The ICU nursing management fee is an admission fee that varies based on the grading determined by nurse-to-bed ratio. Using this grading system, we classified four groups from the highest to the lowest level based on the proportion of beds to nurses (high, high-mid, mid-low, and low group). HAP was defined by the International Classification of Disease, 10th revision (ICD-10) code. Multilevel logistic regression was used to investigate the relationship between the level of ICU nurse staffing and pneumonia, controlling for variables at the individual and hospital levels. Lower levels of nurse staffing were associated with a greater incidence of HAP than higher levels of nurse staffing (mid-high, OR: 1.33, 95% CI: 1.12-1.57; mid-low, OR: 1.61, 95% CI: 1.27-2.04; low, OR: 2.13, 95% CI: 1.67-2.71). The intraclass correlation coefficient value was 0.177, and 17.7% of the variability in HAP was accounted for by the hospital. Higher ICU nursing management fee grades (grade 5 and above) in general and hospital settings were significantly associated with an increased risk of HAP compared to grade 1 admissions. Similarly, in tertiary hospitals, grade 2 and higher ICU nursing management fees were significantly associated with an increased risk of HAP compared to grade 1 admissions. Especially, a lower level of nurse staffing was associated with bacterial pneumonia but not pneumonia due to aspiration. In conclusion, this study found an association between the level of ICU nurse staffing and HAP among surgical patients. A lower level of nurse staffing in the ICU was associated with increased rates of HAP among surgical patients. This indicates that having fewer beds assigned to nurses in the ICU setting is a significant factor in preventing HAP, regardless of the size of the hospital.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisherCambridge University Press-
dc.relation.isPartOfEPIDEMIOLOGY AND INFECTION-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHCritical Care-
dc.subject.MESHHumans-
dc.subject.MESHIntensive Care Units-
dc.subject.MESHNational Health Programs-
dc.subject.MESHNursing Staff, Hospital*-
dc.subject.MESHPneumonia*-
dc.subject.MESHRepublic of Korea-
dc.subject.MESHTertiary Care Centers-
dc.subject.MESHWorkforce-
dc.titleAssociation between nurse staffing level in intensive care settings and hospital-acquired pneumonia among surgery patients: result from the Korea National Health Insurance cohort-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Preventive Medicine (예방의학교실)-
dc.contributor.googleauthorYu Shin Park-
dc.contributor.googleauthorIl Yun-
dc.contributor.googleauthorSuk-Yong Jang-
dc.contributor.googleauthorEun-Cheol Park-
dc.contributor.googleauthorSung-In Jang-
dc.identifier.doi10.1017/S0950268824000232-
dc.contributor.localIdA01618-
dc.contributor.localIdA03432-
dc.contributor.localIdA03439-
dc.relation.journalcodeJ04608-
dc.identifier.eissn1469-4409-
dc.identifier.pmid38326273-
dc.subject.keywordhospital-acquired infection-
dc.subject.keywordhospital-acquired pneumonia-
dc.subject.keywordnursing staff-
dc.subject.keywordquality of care-
dc.contributor.alternativeNamePark, Eun-Chul-
dc.contributor.affiliatedAuthor박은철-
dc.contributor.affiliatedAuthor장석용-
dc.contributor.affiliatedAuthor장성인-
dc.citation.volume152-
dc.citation.startPagee62-
dc.identifier.bibliographicCitationEPIDEMIOLOGY AND INFECTION, Vol.152 : e62, 2024-02-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers

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