护士实践环境,工作满意度,以及营业额和患者下降
Kaili Mauricio1, Amy L Bulger1, Corrine Y Jurgens1
1William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts.
JAMA network open
|February 3, 2026
概括
高级注册护士和先进实践注册护士的周转率增加了患者的下降. 提高护士留守率对于患者安全至关重要,尽管具体的工作满意度的联系有限. 针对有针对性的保留策略需要进一步研究.
科学领域:
- 护理的质量护理的质量
- 患者安全 患者安全
- 医疗保健管理的管理
背景情况:
- 住院患者跌倒是经常发生的不良事件,影响患者的安全和增加医疗保健成本.
- 识别可修改的组织因素对于有效的防摔策略至关重要.
研究的目的:
- 为了调查护士工作满意度,实践环境和患者跌倒之间的关联.
- 确定护士流动是否调解了工作满意度/实践环境和患者下降之间的关系.
主要方法:
- 一项横截面研究,利用来自护理质量指标国家数据库 (2022-2023) 的单位级数据.
- 使用结构方程建模来分析直接和间接的关联.
- 数据包括美国急症医院的医疗,外科和综合单位8584个单位.
主要成果:
- 更高的注册护士 (RN) 和高级实践注册护士 (APRN) 周转率与患者跌倒的增加显著相关 (β=0.01;95% CI,0.01-0.02).
- 护士们的留守意图与更低的营业额有关 (β=-3.50; 95% CI, -6.25至 -0.75).
- 在工作满意度或实践环境和护士周转率下降之间没有发现一致的间接关联.
结论:
- 增加护士轮流量是较高患者跌倒率的重要预测因素.
- 虽然特定的工作满意度指标和跌倒之间的直接联系并不总是显著,但护士的保留对于患者安全至关重要.
- 进一步的研究应该集中在开发有针对性的干预措施,以提高护士的留守率和减轻患者的跌倒.
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