在瑞士长期护理中人员配置模式和压力伤害发生率:一项时间对事件的研究
Catherine Blatter1, Michael Simon1, Franziska Zúñiga1
1Institute of Nursing Science, Faculty of Medicine, University of Basel, Basel, Switzerland.
Journal of the American Medical Directors Association
|December 9, 2025
概括
扩大角色 (RNX) 的注册护士的临床监督班次 (CSSs) 显著降低了长期护理中的压力损伤风险. 有足够的注册护士和适当的认证护士助理的最佳人员配置提高了居民的安全.
科学领域:
- 老年学和老年医疗护理
- 护理和医疗保健管理管理
- 提高患者安全和质量.
背景情况:
- 压力伤害是长期护理 (LTC) 中的一个重大安全问题,由于居民复杂性和人员短缺的增加而加剧.
- 了解护理人员配置对居民安全的影响对于在LTC环境中提供有效护理至关重要.
研究的目的:
- 探索注册护士在扩展角色 (RNX) 中提供的临床监督班次 (CSS) 与压力受伤风险之间的关系.
- 调查直接护理团队技能混合模式与LTC居民压力伤害发生率之间的关联.
主要方法:
- 追溯队列研究利用行政居民和工作人员名单数据从2018年到2023年.
- 包括瑞士一个多处养老院的七个单位的数据,包括所有长期住院居民和护理人员.
- 应用通用添加式考克斯模型来分析CSS和技能混合 (注册护士[RN]和认证护士助理[CNA]) 与压力损伤的关联.
主要成果:
- 分析了1138例入院病例 (937例住院病例),总体压力损伤发生率为17.6%.
- 暴露于CSS与压力损伤风险降低显著相关 (HR,0.99;95% CI,0.98-0.99;P <.001).
- 保护性人员配置模式包括保持至少25%的RN和最多50%的CNA. 当RN水平低于最佳时,增加CNA人员数量比增加持牌实践护士人员数量更具保护性.
结论:
- RNX的CSS与瑞士LTC设施压力损伤的发病率较低有关,近年来这种影响越来越强.
- 这些发现强调了扩大护理角色在应对当前LTC挑战和提高居民安全方面的重要性.
- 建议评估特定的人员配置,特别是RN和CNA的平衡,以优化居民结果和护理质量.
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