护理团队组成和急性住院后的死亡率
Peter Griffiths1,2,3, Christina Saville1,3, Jane Ball1,3
1School of Health Sciences, University of Southampton, Southampton, United Kingdom.
JAMA network open
|August 19, 2024
概括
低护士人员数量增加了患者死亡风险. 使用临时护士来填补短缺,可以减少但不能消除这种风险,挑战他们的成本效益,以确保患者安全.
科学领域:
- 医疗保健管理的管理
- 患者安全 患者安全
- 护理劳动力研究 护理劳动力研究
背景情况:
- 护士人员不足与患者不良结果有关.
- 关于临时工作人员和经验丰富的护士在短缺期间对患者安全的影响存在不确定性.
研究的目的:
- 调查护士团队组成与患者死亡风险之间的关联.
- 确定经验丰富或临时护理人员是否能减轻与人力不足相关的风险.
主要方法:
- 在英格兰的185个医院病房 (2015-2020年) 进行了626,313例患者入院的长度观察研究.
- 在入院后的前5天内,对员工数量和团队组成的自然变化进行分析.
- 混合效应的考克斯比例危险模型用于评估30天死亡率的首要结果.
主要成果:
- 注册护士 (RN) 和护理辅助人员 (NS) 的人员不足显著增加了死亡风险.
- 临时RN比例增加 (10%) 与死亡风险增加2.3%有关.
- 机构NS员工比例增加 (10%) 与死亡风险增加4%相关.
- 高级护士没有减轻与人力不足相关的不良结果.
结论:
- 低护士人才水平与患者死亡率的增加有关.
- 虽然与严重短缺相比,临时工作人员可能会降低风险,但风险仍然很高.
- 依靠临时工作人员来填补短缺可能不是一个具有成本效益的长期战略,以确保患者的安全.
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