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Updated: Sep 3, 2025
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
A cross-sectional study of neonatal intensive care unit overcrowding and understaffing associated with bacterial
Tone-Merete Dahl1,2, Anne Lee Solevåg2,3
1Department of Neonatal Intensive Care, Division of Paediatric and Adolescent Medicine, Stavanger University Hospital, Stavanger, Norway.
Aim:
To study whether overcrowding and/or nurse understaffing preceded four bacterial outbreaks during a 5-year period in a Norwegian university hospital neonatal intensive care unit (NICU).
Methods:
A repeated cross-sectional study based on prospectively collected data from the Norwegian neonatal network's (NNN) web-based electronic database, digital work schedules and information about the outbreaks from logs, reports and publications. Number of admitted patients, category 4-5 patients (i.e., with the highest nurse to patient ratio), rostered nursing staff and nurse specialists were analysed in relation to periods (1) >28 days before individual outbreaks, (2) ≤28 days before, (3) during and (4) after outbreaks. Overcrowding and understaffing were compared between the four periods with Chi-square test and post hoc analysis with Bonferroni correction.
Results:
When all outbreaks were analysed together, overcrowding was more frequent in the periods within 28 days of outbreaks compared to the other periods (p < 0.001). For understaffing, the periods within 28 days of outbreaks were only different from the periods >28 days before outbreaks (p < 0.001). The trends regarding individual outbreaks were less consistent, but there were more category 4-5 patients before and during the outbreaks.
Conclusion:
Bacterial outbreaks in a 5-year period were weakly associated with overcrowding and understaffing.
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