Association of patient to nurse ratio and hand washing stations and infection-related hospitalizations in hemodialysis patients
Bibliographic record
Abstract
Background and Objectives: Infection is the second most common cause of death in the hemodialysis population after cardiovascular disease. However, infection rates tend to vary depending on the dialysis facility. The facility-level variables responsible for this variation are unknown. Methods: A retrospective cohort study was conducted with a cohort of 6,124 adult chronic hemodialysis patients in 21 participating dialysis facilities using linked data from two administrative databases (RAMQ and Med-Echo). Patients were followed from January 1, 2007 to March 31, 2013. Kidney transplant recipients, peritoneal dialysis patients and home hemodialysis patients were excluded. Facility-level variables were obtained by direct measurement or by interviewing the staff at participating facilities. Facility-level variables measured in this study include: patient to nurse ratio, mean distance of dialysis station to hand-washing station or alcohol-based rub dispenser (ABHRD), hand-washing station ratio and ABHRD ratio. The association between these facility-level variables and infection-related hospitalizations (IRH) was estimated using mixed effects Cox models and Kaplan-Meier curves. Results: A patient to nurse ratio of ≥4 (HR = 0.72, 95% CI = 0.55-0.95) and an ABHRD ratio of ≥1.5 (HR = 0.76, 95% CI = 0.60-0.95) were associated with a significantly reduced risk of IRH. A mean distance from the dialysis station to the nearest washing station of <4.75 m (HR = 1.30, 95% CI = 1.03-1.64) and a hand-washing station ratio of <3.15 (HR = 1.38, 95% CI = 1.08-1.76) were associated with a significantly increased risk of IRH. There was no association between mean distance of dialysis station to ABHRD and risk of IRH. However, these associations disappeared depending on the sensitivity analysis done. Conclusion: The association between IRH and the facility-level variables analyzed in this study is unclear.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".