Shuldham Caroline, Parkin Claire, Firouzi Ashi, Roughton Michael, Lau-Walker Margaret
Royal Brompton & Harefield NHS Trust, Sydney Street, London SW3 6NP, UK.
Int J Nurs Stud. 2009 Jul;46(7):986-92. doi: 10.1016/j.ijnurstu.2008.06.004.
Research has shown a direct relationship between staffing levels and patient outcomes for specific nurse-sensitive indicators, with lower patient to nurse ratios (i.e. less patients per nurse) associated with better outcomes.
To explore the relationship between nurse staffing characteristics (the nursing hours worked by permanent and temporary staff and nurse hours per patient day) and patient outcomes: pressure sores, patient falls, upper gastrointestinal bleed, pneumonia, sepsis, shock and deep vein thrombosis.
A case study using retrospective hospital data, at ward level.
A tertiary cardio-respiratory NHS Trust in England, comprising two hospitals.
All patients, including day cases, who were admitted to either hospital as an in-patient over 12 months.
Data were extracted from corporate hospital systems. The clinical areas were categorised as lower dependency, i.e. wards, or critical care which included ICU and high dependency units. The relationship between nurse staffing characteristics and patient outcomes was assessed using either a Poisson or negative binomial regression model as appropriate. We sought to establish whether the outcomes were affected by the nurse hours per patient day, the permanent nurse hours worked as a percentage of the total hours, and the permanent nurse hours worked as a percentage of the permanent and bank hours combined.
In the lower dependency category wards there was only a weak association demonstrated between nurse staffing and the majority of the outcomes. The results from the high dependency critical care areas showed few significant results with only the rate of sepsis being significantly reduced as the ratio of permanent staff hours increased.
The study demonstrated the possibility of using existing hospital data to examine the relationship between nurse staffing and patient outcomes, however the associations found were weak and did not replicate reliably the findings from previous work.
研究表明，对于特定的护理敏感指标，人员配备水平与患者预后之间存在直接关系，患者与护士的比例较低（即每名护士护理的患者较少）与更好的预后相关。
探讨护士人员配备特征（固定和临时工作人员的工作护理时长以及每名患者每天的护士时长）与患者预后之间的关系：压疮、患者跌倒、上消化道出血、肺炎、败血症、休克和深静脉血栓形成。
一项使用医院回顾性数据的病房层面案例研究。
英格兰一家三级心肺国民保健服务信托基金，由两家医院组成。
所有患者，包括日间病例，在12个月内作为住院患者入住其中任何一家医院。
从医院综合系统中提取数据。临床区域分为低依赖区，即病房，或重症监护区，包括重症监护病房和高依赖病房。根据情况使用泊松或负二项回归模型评估护士人员配备特征与患者预后之间的关系。我们试图确定预后是否受到每名患者每天的护士时长、固定护士工作时长占总时长的百分比以及固定护士工作时长占固定和储备护士工作时长总和的百分比的影响。
在低依赖区病房，护士人员配备与大多数预后之间仅显示出微弱的关联。高依赖重症监护区的结果显示几乎没有显著结果，只有随着固定工作人员时长比例的增加，败血症发生率显著降低。
该研究表明利用现有医院数据检查护士人员配备与患者预后之间关系的可能性，然而所发现的关联较弱，且未能可靠地重现先前研究的结果。
