Horn Susan D
Institute for Clinical Outcomes Research, University of Utah School of Medicine, Salt Lake City, UT, USA.
Policy Polit Nurs Pract. 2008 May;9(2):88-93. doi: 10.1177/1527154408320420.
Lower nurse staffing in hospitals has been associated with adverse patient outcomes; results in nursing homes (NHs) are less clear. We examined the association between nurses' direct care time and outcomes in long-stay NH residents and potential cost savings from decreased adverse outcomes versus additional wages for adequate nurse staffing. Data were from the National Pressure Ulcer Long-Term Care Study of 1,376 at-risk residents from 82 NHs. Primary data came from medical records. Hospital, pressure ulcer (PrU) treatment, and urinary tract infection (UTI) costs were from national statistics or cost-identification studies. Time horizon was 1 year. More registered nurse (RN) direct care time/resident/day was associated with fewer PrUs, hospitalizations, and UTIs. Annual net societal benefit was $3,191/resident/year in high-risk NH units with 30-40 min of RN time/resident/day versus units with <10 min. Thus, after controlling for important variables, more RN time/day was strongly associated with better outcomes and lower societal cost.
医院护士配备不足与患者不良预后相关；而在养老院（NHs）中的结果尚不清楚。我们研究了长期居住在养老院的居民中护士直接护理时间与预后之间的关联，以及与因减少不良预后所节省的潜在成本相比，为充足的护士配备支付额外工资的情况。数据来自全国压力性溃疡长期护理研究，该研究涉及82家养老院的1376名高危居民。主要数据来自医疗记录。医院、压力性溃疡（PrU）治疗和尿路感染（UTI）成本来自国家统计数据或成本识别研究。时间跨度为1年。每位居民每天更多的注册护士（RN）直接护理时间与更少的压力性溃疡、住院次数和尿路感染相关。在高危养老院单元中，每位居民每天有30 - 40分钟RN护理时间的单元与每天护理时间少于10分钟的单元相比，每年每位居民的净社会效益为3191美元/年。因此，在控制了重要变量后，每天更多的RN护理时间与更好的预后和更低的社会成本密切相关。
