Aiken L H, Sloane D M, Lake E T, Sochalski J, Weber A L
Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia 19104-6096, USA.
Med Care. 1999 Aug;37(8):760-72. doi: 10.1097/00005650-199908000-00006.
To compare differences in AIDS patients' 30-day mortality and satisfaction with care in dedicated AIDS units, scattered-bed units in hospitals with and without dedicated AIDS units, and in magnet hospitals known to provide good nursing care.
Data were obtained on 1,205 consecutively admitted patients in 40 units in 20 hospitals and on 820 of their nurses.
Mortality was lower and satisfaction was higher for AIDS patients in dedicated AIDS units and in nursing magnet hospitals. Primary nursing, end-of-life care counseling, and discharge planning were also more common. Higher nurse to patient ratios and AIDS physician specialty services were strongly associated with lower mortality. Patient satisfaction was strongly associated with organizational control of care by bedside nurses. Homosexuals were more likely to be admitted to dedicated AIDS units, which largely explains the under-representation of minorities and women.
Dedicated AIDS units and magnet hospitals offer important benefits to AIDS patients, including lower odds on dying within 30 days of admission, higher patient satisfaction, and care meeting professional standards. Better nurse staffing, AIDS physician specialty services, and more organizational control by bedside nurses improve patient outcomes.
比较艾滋病患者在艾滋病专科病房、设有和未设有艾滋病专科病房的医院中的散在病床病房以及以提供优质护理服务著称的磁性医院中30天死亡率及护理满意度的差异。
获取了20家医院40个病房连续收治的1205例患者及其820名护士的数据。
在艾滋病专科病房和磁性医院中，艾滋病患者的死亡率较低，满意度较高。一级护理、临终关怀咨询和出院计划也更为常见。较高的护士与患者比例以及艾滋病专科医生服务与较低的死亡率密切相关。患者满意度与床边护士对护理的组织控制密切相关。同性恋者更有可能入住艾滋病专科病房，这在很大程度上解释了少数族裔和女性代表性不足的原因。
艾滋病专科病房和磁性医院为艾滋病患者带来了重要益处，包括入院30天内死亡几率较低、患者满意度较高以及护理符合专业标准。更好的护士配备、艾滋病专科医生服务以及床边护士更多的组织控制可改善患者预后。
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