Private patient rooms and hospital-acquired methicillin-resistant Staphylococcus aureus: A hospital-level analysis of administrative data from the United States

Park, Sae Hwan; Stockbridge, Erica L.; Miller, Thaddeus L.; O’Neill, Liam

doi:10.1371/journal.pone.0235754

Cited by 7 publications

(11 citation statements)

References 64 publications

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“…Shared rooms and bathroom facilities were also identified by infection control nurses as the primary environmental causes of missed care in the open-ended questions. This finding is supported by a retrospective study exploring the relationship between private rooms and rates of HAIs (Park et al, 2020). Nurses working outside of infection control highlighted failure in environmental cleaning.…”

Section: Discussionmentioning

confidence: 78%

“…Likewise, Van et al (2020) for patients, availability of sinks and access to PPE (Henderson et al, 2020). Park et al (2020) explored the relationship between proportion of private rooms and incidence of health-acquired MRSA (HA-MRSA) in Texas and found that there were 0.8% fewer HA-MRSA infections for each 1% increase in private rooms as a proportion of all rooms. Randle and Clarke (2010) view lack of facilities including side rooms as a barrier to implementation of the code of hygiene, which establishes guidelines for infection prevention in the UK.…”

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confidence: 99%

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Comparing infection control and ward nurses' views of the omission of infection control activities using the Missed Nursing Care Infection Prevention and Control (MNCIPC) Survey

et al. 2021

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Aim To compare the perceptions of nurses with infection control expertise and ward nurses as to what infection control activities are missed and the reasons why these activities are omitted. Background Infection prevention activities are viewed as important for reducing health care‐acquired infections (HAIs) but are often poorly performed. Methods Data were collected through the Missed Nursing Care Infection Prevention and Control (MNCIPC) Survey delivered to 500 Australian nurses prior to COVID‐19. Results Significant differences were found on the mean scores between infection control and other nurses on ten items. In eight cases, five relating to hand hygiene, infection control specialists viewed the activity as more likely to be missed. Factors viewed as having greater contribution to omission of infection control prevention were as follows: 'Patients have to share bathrooms', 'Urgent patient situation' and 'Unexpected rise in patient volume and/or acuity on the ward/unit'. Infection control nurses were more likely to highlight the role of organisational and management factors in preventing effective infection control. Conclusions Differences in response between nurses suggest that the extent of omission of infection control precautions may be under‐estimated by ward nurses. Implications for Nursing Management Infection control specialists are more likely to identify organisational barriers to effective infection control than other nurses. Work demands arising from pandemic management may contribute to infection control precautions being missed.

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Section: Discussionmentioning

confidence: 78%

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confidence: 99%

Comparing infection control and ward nurses' views of the omission of infection control activities using the Missed Nursing Care Infection Prevention and Control (MNCIPC) Survey

et al. 2021

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“…found in an epidemiological study that an increasing proportion of single-bed patient rooms in a hospital was significantly associated with fewer hospital-acquired methicillin-resistant Staphylococcus aureus infections. 20…”

Section: Discussionmentioning

confidence: 99%

“…8–18 Two studies outside ICUs showed positive results regarding the preventive effect of single-bed accommodation on HAIs. 19,20 These findings may indicate that the preventive effect from accommodating patients in single-bed rooms vary depending on the group of patients and type of wards.…”

Section: Introductionmentioning

confidence: 97%

Use of single-bed rooms may decrease the incidence of hospital-acquired infections in geriatric patients: A retrospective cohort study in Central Denmark region

Gregersen

Mellemkjær

Foss

et al. 2021

J Health Serv Res Policy

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Objective Patients accommodated in single-bed rooms may have a reduced risk of hospital-acquired infections (HAIs) compared to those in multi-bed rooms. This study aimed to examine the effect of single-bed accommodation on HAIs in older patients admitted to a geriatric ward. Methods A retrospective cohort study of patients admitted to geriatric wards in a university hospital in Central Denmark Region linked to a move to a newly built hospital, involving all consecutively admitted patients aged 65 years and over from 15 September to 19 December 2016 and a similar cohort admitted in the same three months in 2017. We compared the incidence of HAIs in patients in single-bed accommodation to those in multi-bed accommodation using retrospective review of electronic patient records, with all infections verified microbiologically or by X-ray with onset between 48 hours after admission to 48 hours after discharge from hospital. Results In total 446 patients were included. The incidence of HAIs in multi-bed accommodation was 30% compared to 20% in single-bed accommodation. The hazard ratio was 0.62 (95% Confidence Interval 0.43–0.91, p = 0.01) for single-bed accommodation. This finding remained robust after adjustment for age, sex, infection at admission, risk of sepsis, use of catheter, treatment with prednisone or methotrexate, and comorbidity index. Conclusion Accommodation in single-bed rooms appeared to reduce HAIs compared to multi-bed rooms in two geriatric wards. This finding should be considered as hypothesis-generating and be examined further using an experimental design.

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“…Seven had low quality scores and nine had high quality scores. More than half (n=33) studies reported statistically analysed data.Routine care was assessed in adults in 10 studies(8,69,75,77,79,80,84,87,89,93) and eight involved mixed age populations and care levels that stated or were assumed to include adults and routine care (26,35,36,67,71,72,88,95). Hospital-acquired infection rates were shown to be reduced in single rooms in six studies (26,36,67,69,71,87,88).…”

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confidence: 99%

The clinical, humanistic, and economic outcomes, including experiencing of patient safety events, associated with admitting patients to single rooms compared with shared accommodation for acute hospital admissions. A narrative synthesis systematic literature review

Bertuzzi¹,

Martin

Clarke

et al. 2022

Preprint

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Objectives: Assess the impact of single rooms versus multioccupancy accommodation on inpatient health-care outcomes and processes. Design: Systematic review. Setting: Hospitals and secondary care units. Participants: Inpatients receiving routine, emergency, high-dependency, or intensive care with a named type of hospital accommodation. Main outcome measures: Qualitative synthesis of findings. Results: Of 4,861 citations initially identified, 215 were deemed suitable for full-text review, of which 145 were judged to be relevant to this review. Five main method types were reported: 60 before-and-after comparisons, 75 contemporaneous comparisons, 18 qualitative studies of accommodation preferences, 10 evidence syntheses. All studies had methodological issues that potentially biased the results by not adjusting for confounding factors that are likely to have contributed to the outcomes. Ninety-two papers compared clinical outcomes for patients in single rooms versus shared accommodation, but no clearly consistent conclusions could be drawn about overall benefits of single rooms versus shared accommodation (multioccupancy rooms, bays, or wards). Single rooms were most likely to be associated with a small overall clinical benefit for the most severely ill patients, especially neonates in intensive care. Patients who preferred single rooms tended to do so for privacy, and for reduced disturbances. By contrast, men, older adults, children, and adolescents were more likely to prefer shared accommodation to avoid loneliness. While shared accommodation seemed to be the most cost-effective approach for construction, greater costs associated with building single rooms were small and likely to be recouped over time by other efficiencies. Conclusions: The lack of difference between inpatient accommodation types in a large number of studies suggests that there would be little effect on clinical outcomes, particularly in routine care. Patients in intensive care areas are most likely to benefit from single rooms. Most patients preferred single rooms for privacy and some preferred shared accommodation for avoiding loneliness.

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Private patient rooms and hospital-acquired methicillin-resistant Staphylococcus aureus: A hospital-level analysis of administrative data from the United States

Abstract: To use hospital-level data from the US to determine whether private patient rooms (PPRs) are associated with fewer in hospital-acquired methicillin-resistant Staphylococcus aureus (HA-MRSA) infections.

Cited by 7 publications

References 64 publications

Comparing infection control and ward nurses' views of the omission of infection control activities using the Missed Nursing Care Infection Prevention and Control (MNCIPC) Survey

Comparing infection control and ward nurses' views of the omission of infection control activities using the Missed Nursing Care Infection Prevention and Control (MNCIPC) Survey

Use of single-bed rooms may decrease the incidence of hospital-acquired infections in geriatric patients: A retrospective cohort study in Central Denmark region

The clinical, humanistic, and economic outcomes, including experiencing of patient safety events, associated with admitting patients to single rooms compared with shared accommodation for acute hospital admissions. A narrative synthesis systematic literature review

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