Mark Barbara A, Jones Cheryl Bland, Lindley Lisa, Ozcan Yasar A
University of North Carolina, Chapel Hill, NC, USA.
Policy Polit Nurs Pract. 2009 Aug;10(3):180-6. doi: 10.1177/1527154409346322. Epub 2009 Dec 13.
Using an innovative statistical approach-data envelopment analysis-the authors examined the technical efficiency of 226 medical, surgical, and medical-surgical nursing units in 118 randomly selected acute care hospitals. The authors used the inputs of registered nurse, licensed practical nurse, and unlicensed hours of care; operating expenses; and number of beds on the unit. Outputs included case mix adjusted discharges, patient satisfaction (as a quality measure), and the rates of medication errors and patient falls (as measures of patient safety). This study found that 60% of units were operating at less than full efficiency. Key areas for improvement included slight reductions in labor hours and large reductions in medication errors and falls. The study findings indicate the importance of improving patient safety as a mechanism to simultaneously improve nursing unit efficiency.
作者采用一种创新的统计方法——数据包络分析，对118家随机选取的急症护理医院中226个医疗、外科及医疗 - 外科护理单元的技术效率进行了考察。作者将注册护士、执业护士及无执照护理工时、运营费用以及各单元床位数量作为投入指标。产出指标包括病例组合调整后的出院人数、患者满意度（作为一项质量指标）以及用药错误率和患者跌倒率（作为患者安全指标）。该研究发现，60%的护理单元运行效率未达最高水平。改进的关键领域包括略微减少劳动工时，大幅减少用药错误和跌倒情况。研究结果表明，将提高患者安全作为一种同时提高护理单元效率的机制具有重要意义。
