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病院の看護師の教育レベルと外科患者の死亡率
Linda H Aiken1, Sean P Clarke, Robyn B Cheung
1Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia 19104-6096, USA. laiken@nursing.upenn.edu
JAMA
|September 25, 2003
まとめ
学士号を取得した登録看護師 (RN) の割合が高くなることは,患者のより良い結果と関連しています. 病院におけるBSNで準備されたRNの増加は,手術患者の死亡率の低下と救助に失敗した症例の減少と相関しています.
科学分野:
- 医療の質に関する研究
- 介護教育のインパクト
- 患者の安全性に関する結果
背景:
- 看護師スタッフは,病院のケア品質に影響することが知られているが,登録看護師 (RN) の教育背景が患者のアウトカムに与える具体的な影響は,まだ十分に研究されていない.
- この研究では,病院のRNの教育構成と患者のアウトカムとの関連を調査しています.
研究 の 目的:
- 学士号または高等教育を持つ病院のRNの割合がリスク調整による死亡率と関連しているかどうかを判断する.
- RNの教育レベルと手術患者の救助失敗率 (FTR) の関係を調べる.
主な方法:
- ペンシルベニア州の168の病院 (1998年-1999年) の232,342人の外科患者の横断分析.
- データをリンクした管理,調査,患者の結果,看護師の教育構成と人事レベルを含む.
- リスク調整による死亡率と入院後30日以内のFTRは,看護師の教育レベルと比較して分析された主要な結果指標でした.
主要な成果:
- 学士号を持つRNの割合は,病院によって大きく異なっていました (0%-77%).
- 学士号を持つRNの10%の増加は,30日間の死亡リスクの5%の減少と関連していました (OR,0.95;95%CI,0.91-0.99).
- 同様に,BSNで準備されたRNの10%の増加は,救助に失敗する確率は5%減少した (OR,0.95;95%CI,0.91-0.99) と相関しています.
結論:
- 卒業後修了した登録看護師の割合が高い病院では,手術患者の死亡率が低いことが示されました.
- BSNで教育を受けたRNの増加は,外科患者の救助失敗率の低下と関連していました.
- これらの発見は,より良い患者安全と臨床成果を達成するために,看護教育レベルの重要性を強調しています.
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