Harrington Charlene
Department of Social and Behavioral Sciences, University of California-San Francisco, 3333 California Street, Suite 455, San Francisco, CA 94118, USA.
Nurs Outlook. 2005 Nov-Dec;53(6):300-4. doi: 10.1016/j.outlook.2005.10.002.
Health services research has led to exciting new findings about the critical importance of the amount and type of nursing staff in nursing homes for improving the processes and outcomes of care. This paper reviews recent theoretical and research issues and outlines areas where research is needed. The nursing home research agenda for the future needs to concentrate on: (1) the relationship between structural measures of nursing (eg, staffing levels, education, turnover rates) and the outcomes and processes of care; (2) adequate processes of care and ways to improve the reliability of clinical outcome measures; (3) better ways to risk-adjust for resident characteristics; (4) the impact of nursing home characteristics (eg, ownership) and public policies (eg, reimbursement) on structural factors, processes, and outcomes; and (5) cost-effectiveness studies of nursing care at the organizational or system level.
卫生服务研究带来了令人振奋的新发现，即养老院护理人员的数量和类型对于改善护理流程及护理结果至关重要。本文回顾了近期的理论和研究问题，并概述了需要开展研究的领域。未来养老院研究议程需集中于：（1）护理的结构性指标（如人员配备水平、教育程度、周转率）与护理结果及流程之间的关系；（2）充足的护理流程以及提高临床结果测量可靠性的方法；（3）针对居民特征进行风险调整的更好方法；（4）养老院特征（如所有权）和公共政策（如报销）对结构因素、流程及结果的影响；以及（5）组织或系统层面护理的成本效益研究。
