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Journal Article > Study
Universal screening for methicillin-resistant Staphylococcus aureus at hospital admission and nosocomial infection in surgical patients.
Harbarth S, Fankhauser C, Schrenzel J, et al. JAMA. 2008;299:1149-1157.
Patients who are colonized with methicillin-resistant Staphylococcus aureus (MRSA) are at risk for infections, particularly after undergoing surgery, and may also transmit the bacteria to other patients if hospital staff do not follow proper infection control practices. This study evaluated one widely advocated strategy for reducing MRSA infections: screening all patients for MRSA at admission. Although the hospital had a relatively high rate of MRSA colonization, the intervention did not reduce nosocomial MRSA infections. Despite these results, universal screening for MRSA is likely to become increasingly common in hospitals, as several states have passed legislation mandating this practice.
Audiovisual > Image/Poster
Nagpal K, Arora S, Abboudi M, et al. Ann Surg. 2010;252:171-176.
This qualitative study interviewed 18 providers and found that postoperative handovers are informal, unstructured, and fraught with inconsistent and incomplete information transfer. These data were used to develop and validate a formal handover protocol. Prior studies have used insights from Formula One auto racing to inform improvement strategies for postoperative handoffs, and the World Health Organization's Surgical Safety Checklist explicitly emphasizes structured handoffs at the time of patient transfer from the operating room to the postoperative area.
Journal Article > Study
Post-operative mortality, missed care and nurse staffing in nine countries: a cross-sectional study.
Ball JE, Bruyneel L, Aiken LH, et al; RN4Cast Consortium. Int J Nurs Stud. 2018;78:10-15.
Missed nursing care may result from inadequate nurse staffing and explain the relationship between nurse-to-patient ratios and patient outcomes. Research has shown that higher nurse staffing levels are associated with lower inpatient mortality and that reduced staffing increases the risk for postoperative complications. In this study, investigators examined data from more than 400,000 surgical patients from 300 hospitals in 9 countries as well as survey responses from 26,516 nurses. They found a significant association between nurse staffing and missed nursing care with 30-day risk-adjusted postoperative mortality. The authors conclude that measuring missed nursing care may help identify patients at greater risk for adverse outcomes earlier in their course. A past WebM&M commentary highlighted important issues associated with nurse staffing ratios.