Rafferty Anne Marie, Clarke Sean P, Coles James, Ball Jane, James Philip, McKee Martin, Aiken Linda H
Florence Nightingale School of Nursing and Midwifery, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK.
Int J Nurs Stud. 2007 Feb;44(2):175-82. doi: 10.1016/j.ijnurstu.2006.08.003. Epub 2006 Oct 24.
Despite growing evidence in the US, little evidence has been available to evaluate whether internationally, hospitals in which nurses care for fewer patients have better outcomes in terms of patient survival and nurse retention.
To examine the effects of hospital-wide nurse staffing levels (patient-to-nurse ratios) on patient mortality, failure to rescue (mortality risk for patients with complicated stays) and nurse job dissatisfaction, burnout and nurse-rated quality of care.
Cross-sectional analysis combining nurse survey data with discharge abstracts.
Nurses (N=3984) and general, orthopaedic, and vascular surgery patients (N=118752) in 30 English acute trusts.
Patients and nurses in the quartile of hospitals with the most favourable staffing levels (the lowest patient-to-nurse ratios) had consistently better outcomes than those in hospitals with less favourable staffing. Patients in the hospitals with the highest patient to nurse ratios had 26% higher mortality (95% CI: 12-49%); the nurses in those hospitals were approximately twice as likely to be dissatisfied with their jobs, to show high burnout levels, and to report low or deteriorating quality of care on their wards and hospitals.
Nurse staffing levels in NHS hospitals appear to have the same impact on patient outcomes and factors influencing nurse retention as have been found in the USA.
尽管在美国有越来越多的证据，但在国际上，几乎没有证据可用于评估护士护理患者较少的医院在患者生存率和护士留用率方面是否有更好的结果。
研究全院护士人员配备水平（患者与护士比例）对患者死亡率、抢救失败率（病情复杂患者的死亡风险）以及护士工作不满、倦怠和护士评定的护理质量的影响。
将护士调查数据与出院摘要相结合的横断面分析。
30家英国急性信托医院的护士（N = 3984）以及普通、骨科和血管外科患者（N = 118752）。
在人员配备水平最有利（患者与护士比例最低）的医院四分位数中的患者和护士，其结果始终比人员配备不太有利的医院中的患者和护士更好。患者与护士比例最高的医院中的患者死亡率高26%（95%可信区间：12 - 49%）；这些医院中的护士对工作不满、表现出高度倦怠以及报告病房和医院护理质量低或恶化的可能性约为其他医院护士的两倍。
英国国民医疗服务体系（NHS）医院的护士人员配备水平对患者结果以及影响护士留用的因素的影响，似乎与在美国发现的情况相同。
