临时护士的使用与急性护理医院病房中护士和患者安全结果的关系

Use of temporary nurses and nurse and patient safety outcomes in acute care hospital units.

机构信息

School of Nursing, University at Buffalo, The State University of New York, USA.

出版信息

Health Care Manage Rev. 2010 Oct-Dec;35(4):333-44. doi: 10.1097/HMR.0b013e3181dac01c.

DOI:10.1097/HMR.0b013e3181dac01c

PMID:20844353

Abstract

BACKGROUND

To deal with nursing shortages and inadequate hospital nurse staffing, many solutions have been tried, including utilizing temporary nurses. Relatively little attention has been given to use of temporary nurses and its association with both nurse and patients outcomes.

PURPOSE

: The purpose of this study is to investigate the association between use of temporary nurses and nurse (needlesticks and back injuries) and patient (patient falls and medication errors) safety outcomes at the nursing unit level.

METHODOLOGY/APPROACH: Data came from a large organizational study which investigated the relationship between registered nurse (RN) staffing adequacy, work environments, organizational, and patient outcomes. The sample for this study was 4,954 RNs on 277 nursing units in 142 hospitals.

FINDINGS

Nurses working on nursing units with high levels (more than 15%) of external temporary RN hours were more likely to report back injuries than nurses working on nursing units that did not use external temporary RNs. Nurses working on these nursing units also reported greater levels of patient falls compared with those who did not use temporary RNs. This study found that nurses working on nursing units with moderate levels (5-15%) of external temporary RN hours reported fewer medication errors than those without using any external temporary RNs.

PRACTICE IMPLICATIONS

Hospitals need to monitor the levels of temporary nurse use and maintain a level of approximately 15% to ensure both nurse and patient safety outcomes. The temporary nurse use to manage nursing shortfall may provide both benefit and harm to nurse and patient safety depending on the level of the use.

摘要

背景

为了解决护理人员短缺和医院护士人手不足的问题，已经尝试了许多解决方案，包括使用临时护士。相对较少关注使用临时护士及其与护士和患者结果的关系。

目的

本研究旨在调查护理单元层面上使用临时护士与护士（针刺伤和背部受伤）和患者（患者跌倒和用药错误）安全结果之间的关联。

方法/方法：数据来自一项大型组织研究，该研究调查了注册护士（RN）人员配备充足性、工作环境、组织和患者结果之间的关系。本研究的样本包括 142 家医院 277 个护理单元的 4954 名 RN。

结果

在使用外部临时 RN 小时数较高（超过 15%）的护理单元工作的护士比在不使用外部临时 RN 的护理单元工作的护士更有可能报告背部受伤。与不使用临时 RN 的护士相比，在这些护理单元工作的护士还报告了更高水平的患者跌倒。本研究发现，在使用外部临时 RN 小时数中等（5-15%）的护理单元工作的护士报告的用药错误比不使用任何外部临时 RN 的护士少。