McGillis Hall Linda, Doran Diane, Baker G Ross, Pink George H, Sidani Souraya, O'Brien-Pallas Linda, Donner Gail J
Nursing Effectiveness, Utilization, and Outcomes Research Unit, Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Med Care. 2003 Sep;41(9):1096-109. doi: 10.1097/01.MLR.0000084180.07121.2B.
Little research has been conducted that examined the intended effects of nursing care on clinical outcomes.
The objective of this study was to evaluate the impact of different nurse staffing models on the patient outcomes of functional status, pain control, and patient satisfaction with nursing care.
A repeated-measures study was conducted in all 19 teaching hospitals in Ontario, Canada.
The sample comprised hospitals and adult medical-surgical and obstetric inpatients within those hospitals.
The patient's functional health outcomes were assessed with the Functional Independence Measure (FIM) and the Medical Outcome Study SF-36. Pain was assessed with the Brief Pain Inventory and patient perceptions of nursing care were measured with the nursing care quality subscale of the Patient Judgment of Hospital Quality Questionnaire.
The proportion of regulated nursing staff on the unit was associated with better FIM scores and better social function scores at hospital discharge. In addition, a mix of staff that included RNs and unregulated workers was associated with better pain outcomes at discharge than a mix that involved RNs/RPNs and unregulated workers. Finally, patients were more satisfied with their obstetric nursing care on units where there was a higher proportion of regulated staff.
The results of this study suggest that a higher proportion of RNs/RPNs on inpatient units in Ontario teaching hospitals is associated with better clinical outcomes at the time of hospital discharge.
很少有研究探讨护理对临床结果的预期影响。
本研究的目的是评估不同护士人员配置模式对患者功能状态、疼痛控制及患者对护理满意度等结局的影响。
在加拿大安大略省的所有19家教学医院进行了一项重复测量研究。
样本包括医院以及这些医院内的成人内科/外科和产科住院患者。
采用功能独立性测量量表（FIM）和医学结局研究简表36项健康调查（SF-36）评估患者的功能健康结局。采用简明疼痛问卷评估疼痛情况，并用医院质量患者评价问卷中的护理质量子量表测量患者对护理的看法。
病房中注册护士的比例与出院时更好的FIM评分及更好的社会功能评分相关。此外，与由注册护士/注册实践护士和非注册工作人员组成的人员配置相比，由注册护士和非注册工作人员组成的人员配置与出院时更好的疼痛结局相关。最后，在注册工作人员比例较高的病房，患者对产科护理更满意。
本研究结果表明，安大略省教学医院住院病房中较高比例的注册护士/注册实践护士与出院时更好的临床结局相关。
