Reorganization of nurse scheduling reduces the risk of healthcare associated infections

ABSTRACT Background Efficient prevention and control of healthcare associated infections (HAIs) is still an open problem. Objective To design efficient hospital infection control strategies by reorganizing nurse scheduling. Design, setting, and participants Proof-of-concept modeling study based on high-resolution contact data from wearable sensors between patients, nurses, doctors, and administrative staff at a short-stay geriatric ward of a University hospital. Methods We considered isolation and contact removal to identify the most important class of individuals for HAI dissemination. We introduced a novel intervention based on the reorganization of nurse scheduling. This strategy switches and reassigns nurses’ tasks through the optimization of shift timelines, while respecting feasibility constraints and satisfying patient-care requirements. We evaluated the impact of interventions through a Susceptible-Colonized-Susceptible transmission model on the empirical and reorganized contacts. Results Isolation and contact removal produced the largest risk reduction when acting on nurses. Reorganizing their schedules reduced HAI risk by 27% (95% confidence interval [24,29]%) while preserving the timeliness, number, and duration of contacts. More than 30% nurse-nurse contacts should be avoided to achieve an equivalent reduction through simple contact removal. No overall change in the number of nurses per patient resulted from the intervention. Conclusions Reorganization of nurse scheduling offers an alternative change of practice that substantially limits HAI risk in the ward while ensuring the timeliness and quality of healthcare services. This calls for including optimization of nurse scheduling practices in programs for better infection control in hospitals.