Evaluating the efficacy of nursing interventions in reducing infection rates among emergency department patients

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing Pub Date : 2025-07-11 DOI:10.1016/j.ienj.2025.101650

Haijuan Cui, Haitang Wang

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引用次数: 0

Abstract

Background

Healthcare-associated infections (HAIs) are a significant concern in emergency departments (EDs), where high patient volumes, rapid decision-making, and frequent invasive procedures increase infection risks. Despite existing infection prevention measures, the effectiveness of nursing interventions in reducing HAIs in ED settings remains underexplored.

Objective

This study evaluates the efficacy of nursing interventions in reducing HAIs among ED patients through a systematic review and meta-analysis, identifying the most effective strategies and providing evidence-based recommendations for infection control.

Methods

A systematic review and meta-analysis were conducted following PRISMA guidelines. A comprehensive search of PubMed, Cochrane Library, Scopus, and Web of Science was performed to identify relevant studies assessing nursing-led interventions for infection prevention in EDs. Eligible studies included randomized controlled trials (RCTs), quasi-experimental studies, and observational research reporting infection rates as primary outcomes. A random-effects model was used to estimate pooled effect sizes, and subgroup analyses explored the relative effectiveness of different intervention types (hygiene protocols, care bundles, patient education, environmental cleaning). Heterogeneity was assessed using I2 statistics, and publication bias was examined using funnel plots and Egger’s test.

Results

Ten high-quality studies involving 5,500 patients were included. The pooled odds ratio (OR) for nursing interventions in reducing HAIs was 0.69 (95 % CI: 0.65–0.74, p < 0.001), indicating a 31 % reduction in infection odds. Hygiene protocols demonstrated the greatest efficacy (OR = 0.62, 95 % CI: 0.57–0.68, p < 0.001), followed by care bundles (OR = 0.68, 95 % CI: 0.61–0.75, p < 0.001) and environmental cleaning (OR = 0.75, 95 % CI: 0.68–0.82, p < 0.001). Heterogeneity was moderate (I2 = 40 %), with higher variability in care bundles and environmental cleaning interventions. Sensitivity analyses confirmed the robustness of findings, and publication bias was minimal (Egger’s test, p = 0.18).

Conclusion

Nursing interventions significantly reduce HAIs in EDs, with hygiene protocols and care bundles being the most effective. Standardizing infection prevention protocols, integrating evidence-based nursing interventions, and ensuring adherence to best practices can enhance patient safety. Future research should explore the long-term sustainability of these interventions, the impact of multifaceted approaches, and their effectiveness across diverse patient populations.

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评估护理干预对降低急诊科患者感染率的效果

背景：医疗保健相关感染（HAIs）是急诊科（EDs）的一个重要问题，在急诊科，大量患者、快速决策和频繁的侵入性手术增加了感染风险。尽管有现有的感染预防措施，但护理干预在减少急诊科环境中HAIs方面的有效性仍未得到充分探讨。目的本研究通过系统回顾和荟萃分析，评估护理干预在降低ED患者HAIs中的效果，确定最有效的策略，并为感染控制提供循证建议。方法按照PRISMA指南进行系统评价和荟萃分析。我们对PubMed、Cochrane Library、Scopus和Web of Science进行了综合检索，以确定评估护理主导干预措施对急诊科感染预防的相关研究。符合条件的研究包括随机对照试验（rct）、准实验研究和以感染率为主要结果的观察性研究。随机效应模型用于估计合并效应大小，亚组分析探讨了不同干预类型（卫生方案、护理包、患者教育、环境清洁）的相对有效性。采用I2统计量评估异质性，采用漏斗图和Egger检验检验发表偏倚。结果纳入10项高质量研究，共纳入5500例患者。护理干预降低高死亡率的合并优势比（OR）为0.69 (95% CI: 0.65-0.74, p <；0.001)，表明感染几率降低了31%。卫生方案的效果最好(OR = 0.62, 95% CI: 0.57-0.68, p <；0.001)，其次是护理包(OR = 0.68, 95% CI: 0.61-0.75, p <；0.001)和环境清洁(OR = 0.75, 95% CI: 0.68-0.82, p <；0.001)。异质性为中等（I2 = 40%），在护理包和环境清洁干预措施方面具有较高的可变性。敏感性分析证实了研究结果的稳健性，发表偏倚最小（Egger检验，p = 0.18）。结论护理干预措施可显著降低急诊科患者的高死亡率，其中卫生方案和护理包最有效。使感染预防方案标准化，整合循证护理干预措施，并确保遵守最佳做法，可加强患者安全。未来的研究应该探索这些干预措施的长期可持续性，多方面方法的影响，以及它们在不同患者群体中的有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Emergency Nursing NURSING-

CiteScore

3.20

自引率

11.10%

发文量

期刊介绍： International Emergency Nursing is a peer-reviewed journal devoted to nurses and other professionals involved in emergency care. It aims to promote excellence through dissemination of high quality research findings, specialist knowledge and discussion of professional issues that reflect the diversity of this field. With an international readership and authorship, it provides a platform for practitioners worldwide to communicate and enhance the evidence-base of emergency care. The journal publishes a broad range of papers, from personal reflection to primary research findings, created by first-time through to reputable authors from a number of disciplines. It brings together research from practice, education, theory, and operational management, relevant to all levels of staff working in emergency care settings worldwide.