Factors Associated With Removal of Urinary Catheters After Surgery

Read, Catherine; Shindul-Rothschild, Judith; Flanagan, Jane; Stamp, Kelly D.

doi:10.1097/ncq.0000000000000287

Cited by 1 publication

(1 citation statement)

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“…This finding is consistent with previous research. 29 However, our work does not provide information about education initiatives to address sepsis or about which protocols implemented in institutions are correlated with improved patient safety outcomes such as a reduction in sepsis rates.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With the Rate of Sepsis After Surgery

Flanagan

Read

Shindul-Rothschild

2020

Critical Care Nurse

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Background Sepsis is a critical illness that requires early detection and intervention to prevent disability and/or death. Objective To analyze the association between various hospital-related factors and rates of sepsis after surgery in Massachusetts hospitals. Methods The sample consisted of 53 hospitals with intensive or critical care units and 25 hospitals with step-down units. Hospital characteristics, staffing levels, and health care–acquired conditions were examined using publicly available data. Analysis of variance and linear regression were performed to explore the relationship between nurse and physician staffing levels and sepsis rates. Results Sepsis rates were significantly lower when nurses cared for fewer patients (P < .001) and when intensivist hours were greater (P = .03). Linear regression for nurse staffing revealed that higher rates of catheter-associated urinary tract infection (P = .001) and higher numbers of step-down patients cared for by nurses (P = .001) were associated with a significantly higher rate of sepsis (P < .001). Linear regression for physician staffing revealed that higher rates of catheter-associated urinary tract infection (P < .001) and wound dehiscence after surgery (P < .001), greater hospitalist hours (P = .001), and greater physician hours (P = .05) were associated with a significantly higher sepsis rate, while greater intensivist hours were associated with a lower sepsis rate (P = .002). Conclusion In this study, greater nurse staffing and intensivist hours were associated with significantly lower rates of sepsis, whereas greater physician staffing and hospitalist hours were associated with significantly higher rates. Further research is needed to understand the roles of the various types of providers and the reasons for their differing effects on sepsis rates.

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Section: Discussionmentioning

confidence: 99%