更多地利用加班和代理护士和患者安全
Patricia Pittman1, Hong-Lun Tiunn1, Qian Luo1
1Fitzhugh Mullan Institute for Health Workforce Equity, The George Washington University, Washington, DC.
JAMA network open
|April 2, 2025
概括
增加护士加班和代理护士工作时间与更高的压力率有关. 医院应监测这些人员配置策略,以保持患者安全,并确定安全门.
科学领域:
- 医疗保健管理的管理
- 患者安全 患者安全
- 护理工作人员护理人员
背景情况:
- 护士加班和代理护士的使用量有所增加,需要对其对患者安全的影响进行评估.
- 了解替代护理人员配置模式的局限性和机遇对于提供高质量的医疗保健至关重要.
研究的目的:
- 调查加班和机构护士工作时间与美国医院患者安全结果之间的关联.
- 确定护士人员密度的潜在安全门.
主要方法:
- 一项质量改进研究分析了2019年1月至2022年12月期间来自70家美国医院的数据.
- 用Poisson回归和结构断点分析,对每天的患者正常,加班和机构护理时间进行了评估,以评估患者安全指标.
- 根据医院特征,患者病例组合和COVID-19人口普查进行了调整.
主要成果:
- 超过护士加班和机构人员的安全门与压力的增加率有关.
- 机构护士工作时间超过了安全门的140.0%,加班时间超过了63.6%,与压力率的增加相关.
- 代理时间显示与术后出血或血液瘤率有显著的关联,但没有确定门.
结论:
- 护士加班和代理护士工作时间都与压力的发病率显著增加有关.
- 医院可以利用自己的数据来建立和监测护理人员的安全人事门.
- 调查结果强调了管理替代护理人员策略的重要性,以减轻患者安全风险.
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