Changes in nursing team composition and risk of device-associated infection in intensive care units

•Nursing team variables beyond nurse:patient ratios may affect team ability to focus on infection prevention in critically ill patients.•Nursing shift staffing records were used to investigate if periods of relative staffing vulnerabilty were associated with periods of risk occuring a few days before a device associated infection.•Changes in team composition may be associated with acquisition of device associated infection in vulnerable patients. The relationship between nursing staffing levels and healthcare-associated infections (HAIs) has been explored previously with conflicting results. This study uses daily shift records from 2 intensive care units (ICUs) to evaluate whether nuanced changes in nursing team composition impacts subsequent risk for device associated HAIs. Staffing deficiencies may be associated with periods of risk prior to central line-associated bloodstream infection in the ICU.