Rural hospital bed management practices during influenza season
Introduction: Rural health services face greater challenges in managing infectious patients due to lack of specialty beds and longer lengths of stay. The pressures of seasonal influxes of influenza patients with a heavy burden of chronic disease and an ageing population result in an increased dem...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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James Cook University
2022-02-01
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| Series: | Rural and Remote Health |
| Subjects: | |
| Online Access: | https://www.rrh.org.au/journal/article/7015/ |
| _version_ | 1819283840972095488 |
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| author | Colleen Ma Chen Pettit Michelle Giles Se Ok Ohr Michelle Bolte |
| author_facet | Colleen Ma Chen Pettit Michelle Giles Se Ok Ohr Michelle Bolte |
| author_sort | Colleen Ma |
| collection | DOAJ |
| description |
Introduction: Rural health services face greater challenges in managing infectious patients due to lack of specialty beds and longer lengths of stay. The pressures of seasonal influxes of influenza patients with a heavy burden of chronic disease and an ageing population result in an increased demand for hospital beds. During these peak periods it is common for rural hospitals to experience bed block. The result is that patients may be placed into any available bed or ward at the time, increasing the need for transfer and the risk of spreading hospital-acquired respiratory illnesses to other patients and staff across the hospital. This further exacerbates bed block, with patients then requiring more specialised treatment and longer lengths of stay. This places additional strain on already existing workforce shortages and limited resources that must accommodate higher-than-normal patient loads. The objective of this study was to examine rural hospital bed management practices with a focus on the transfer of patients who are actively diagnosed with influenza (either on admission or during their stay in hospital) and to investigate the association of increased bed movement with the rate of nosocomial transmission and staff workload.
Methods: The rates of patients admitted to a rural hospital in New South Wales, Australia, during the yearly peak influenza season (July to September) during 2016-2019 with either community-acquired or hospital-acquired influenza were examined using an infection control surveillance program. Bed management practices related to these inpatients were audited to examine their contribution towards nosocomial transmissions and staff workload during these periods.
Results: A total of 229 patients presented to this hospital with an influenza diagnosis over the study period and generated 175 bed transfers. Forty percent of community-acquired and 70% of hospital-acquired influenza inpatients experienced one or more intrahospital bed transfers during their active infection period. Half of all bed transfers involved patients being transferred to another ward (interward) and the other half consisted of those transferred within the same ward (intraward). These transfers impacted staff workload, requiring a total of 245 extra hours from nursing and cleaning staff to facilitate - time not included when allocating staff at the start of each shift.
Conclusion: Findings from this study indicate that there is no active strategy for influenza containment during high-occupancy periods for this rural facility. This resulted in multiple bed transfers occurring during the active phase of influenza infection. This then led to an exacerbation of bed block and thus further inappropriate placement of newly admitted patients. The development of an optimal bed management plan for future surges of influenza and other highly infectious respiratory illnesses is essential to reduce nosocomial infection and staff workload, especially given the limited resources available in rural areas compared to metropolitan centres.
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| first_indexed | 2024-12-24T01:37:53Z |
| format | Article |
| id | doaj.art-185c8a8f6662496ab0486242bac01860 |
| institution | Directory Open Access Journal |
| issn | 1445-6354 |
| language | English |
| last_indexed | 2024-12-24T01:37:53Z |
| publishDate | 2022-02-01 |
| publisher | James Cook University |
| record_format | Article |
| series | Rural and Remote Health |
| spelling | doaj.art-185c8a8f6662496ab0486242bac018602022-12-21T17:22:08ZengJames Cook UniversityRural and Remote Health1445-63542022-02-012210.22605/RRH7015Rural hospital bed management practices during influenza seasonColleen Ma0Chen Pettit1Michelle Giles2Se Ok Ohr3Michelle Bolte4Tamworth Rural Referral Hospital, Dean Street, Tamworth, NSW 2340, AustraliaTamworth Rural Referral Hospital, Dean Street, Tamworth, NSW 2340, AustraliaHunter New England Nursing & Midwifery Research Centre, James Fletcher Campus, Gate Cottage, 72 Watt Street, Newcastle, NSW 2300, AustraliaHunter New England Nursing & Midwifery Research Centre, James Fletcher Campus, Gate Cottage, 72 Watt Street, Newcastle, NSW 2300, AustraliaInfection Prevention Service, Tamworth Rural Referral Hospital, Dean Street, Tamworth, NSW 2340, Australia Introduction: Rural health services face greater challenges in managing infectious patients due to lack of specialty beds and longer lengths of stay. The pressures of seasonal influxes of influenza patients with a heavy burden of chronic disease and an ageing population result in an increased demand for hospital beds. During these peak periods it is common for rural hospitals to experience bed block. The result is that patients may be placed into any available bed or ward at the time, increasing the need for transfer and the risk of spreading hospital-acquired respiratory illnesses to other patients and staff across the hospital. This further exacerbates bed block, with patients then requiring more specialised treatment and longer lengths of stay. This places additional strain on already existing workforce shortages and limited resources that must accommodate higher-than-normal patient loads. The objective of this study was to examine rural hospital bed management practices with a focus on the transfer of patients who are actively diagnosed with influenza (either on admission or during their stay in hospital) and to investigate the association of increased bed movement with the rate of nosocomial transmission and staff workload. Methods: The rates of patients admitted to a rural hospital in New South Wales, Australia, during the yearly peak influenza season (July to September) during 2016-2019 with either community-acquired or hospital-acquired influenza were examined using an infection control surveillance program. Bed management practices related to these inpatients were audited to examine their contribution towards nosocomial transmissions and staff workload during these periods. Results: A total of 229 patients presented to this hospital with an influenza diagnosis over the study period and generated 175 bed transfers. Forty percent of community-acquired and 70% of hospital-acquired influenza inpatients experienced one or more intrahospital bed transfers during their active infection period. Half of all bed transfers involved patients being transferred to another ward (interward) and the other half consisted of those transferred within the same ward (intraward). These transfers impacted staff workload, requiring a total of 245 extra hours from nursing and cleaning staff to facilitate - time not included when allocating staff at the start of each shift. Conclusion: Findings from this study indicate that there is no active strategy for influenza containment during high-occupancy periods for this rural facility. This resulted in multiple bed transfers occurring during the active phase of influenza infection. This then led to an exacerbation of bed block and thus further inappropriate placement of newly admitted patients. The development of an optimal bed management plan for future surges of influenza and other highly infectious respiratory illnesses is essential to reduce nosocomial infection and staff workload, especially given the limited resources available in rural areas compared to metropolitan centres. https://www.rrh.org.au/journal/article/7015/Australiacross-infectionhospitalsinfection controlinfluenza. |
| spellingShingle | Colleen Ma Chen Pettit Michelle Giles Se Ok Ohr Michelle Bolte Rural hospital bed management practices during influenza season Rural and Remote Health Australia cross-infection hospitals infection control influenza. |
| title | Rural hospital bed management practices during influenza season |
| title_full | Rural hospital bed management practices during influenza season |
| title_fullStr | Rural hospital bed management practices during influenza season |
| title_full_unstemmed | Rural hospital bed management practices during influenza season |
| title_short | Rural hospital bed management practices during influenza season |
| title_sort | rural hospital bed management practices during influenza season |
| topic | Australia cross-infection hospitals infection control influenza. |
| url | https://www.rrh.org.au/journal/article/7015/ |
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