护理SCI晨读:护士人员配备与住院死亡率之间的关联:轮班水平回顾性纵向研究

2021
05/23

+
分享
评论
NursingResearch护理研究前
A-
A+

部分医院通过减少护士人数或降低合格护士人数来做出回应。

护理SCI晨读:

护士人员配备与住院死亡率之间的关联:

轮班水平回顾性纵向研究

 

 



分享智慧

共同成长


摘要

背景

全球各大医院均面临降低成本的压力。部分医院通过减少护士人数或降低合格护士人数来做出回应。

目的

本研究旨在探索患者死亡率与不同班次之间护士人数高低的关系。

方法

这项纵向研究使用了一家瑞士大学医院三年(2015-2017年)的常规班次、单位和患者水平的数据。分析了来自55个单位、79,893名成人住院患者和3646名护士(2670名注册护士,438名持照执业护士和538名无执照和行政人员)的数据。在建立人员配备模型以识别高人员和低人员班次后,拟合逻辑回归模型以探索护士人员配备与患者死亡率之间的关联。

结果

高水平注册护士轮班下的患者死亡率降低了8.7%[OR=0.91 95%CI 0.89-0.93]。相反,人员少则死亡率高10%[OR=1.10 95%CI 1.07-1.13]。死亡率与其他群体配置之间的关联还不清楚。例如,无执照人员和行政人员的高、低人员配置分别与较高的死亡率相关,OR分别为1.03 [95%CI 1.01-1.04]和1.04 [95%CI 1.03-1.06]。

讨论与启示

这项患者水平的纵向研究表明,注册护士的人员配备水平与死亡率之间存在关联。注册护士的较高水平对患者的结局产生积极影响(即较低的死亡率),而较低的水平则具有负面影响(即较高的死亡率)。但尚不清楚其他三个组对患者安全的贡献。因此,不建议将任何一组替换为注册护士。

Abstract

Background

 Worldwide, hospitals face pressure to reduce costs. Some respond by working with a reduced number of nurses or less qualified nursing staff.

Objective

This study aims at examining the relationship between mortality and patient exposure to shifts with low or high nurse staffing.

Methods

This longitudinal study used routine shift-, unit-, and patient-level data for three years (2015-2017) from one Swiss university hospital. Data from 55 units, 79,893 adult inpatients and 3646 nurses (2670 registered nurses, 438 licensed practical nurses, and 538 unlicensed and administrative personnel) were analyzed. After developing a staffing model to identify high- and low-staffed shifts, we fitted logistic regression models to explore associations between nurse staffing and mortality.

Results

Exposure to shifts with high levels of registered nurses had lower odds of mortality by 8.7% [odds ratio 0.91 95% CI 0.89-0.93]. Conversely, low staffing was associated with higher odds of mortality by 10% [odds ratio 1.10 95% CI 1.07-1.13]. The associations between mortality and staffing by other groups was less clear. For example, both high and low staffing of unlicensed and administrative personnel were associated with higher mortality, respectively 1.03 [95% CI 1.01-1.04] and 1.04 [95% CI 1.03-1.06].

Discussion and implications

This patient-level longitudinal study suggests a relationship between registered nurses staffing levels and mortality. Higher levels of registered nurses positively impact patient outcome (i.e. lower odds of mortality) and lower levels negatively (i.e. higher odds of mortality). Contributions of the three other groups to patient safety is unclear from these results. Therefore, substitution of either group for registered nurses is not recommended.




原文链接:

https://www.sciencedirect.com/science/article/pii/S0020748921000936


THE

END

本文由作者自行上传,并且作者对本文图文涉及知识产权负全部责任。如有侵权请及时联系(邮箱:nanxingjun@hmkx.cn
关键词:
回顾性,死亡率,护士,纵向,轮班

人点赞

收藏

人收藏

打赏

打赏

我有话说

0条评论

0/500

评论字数超出限制

表情
评论

为你推荐

推荐课程


社群

精彩视频

您的申请提交成功

确定 取消
剩余5
×

打赏金额

认可我就打赏我~

1元 5元 10元 20元 50元 其它

打赏

打赏作者

认可我就打赏我~

×

扫描二维码

立即打赏给Ta吧!

温馨提示:仅支持微信支付!