School of Nursing, The University of North Carolina at Chapel Hill, NC 27599-7460, USA.
Nurs Res. 2011 Mar-Apr;60(2):107-14. doi: 10.1097/NNR.0b013e31820bb0c6.
Researchers who examine the relationship between nurse staffing and quality of care frequently rely on the Medicare case mix index to adjust for patient acuity, even though it was developed originally based on medical diagnoses and may not accurately reflect patients' needs for nursing care.
The aim of this study was to examine the differences between unadjusted measures of nurse staffing (registered nurses per 1,000 adjusted patient days) and case mix adjusted nurse staffing and nurse staffing adjusted with nursing intensity weights, which were developed to reflect patients' needs for nursing care.
Secondary data were used from 579 hospitals in 13 states from 2000 to 2006. Included were three measures of nurse staffing and hospital characteristics including ownership, geographic location, teaching status, hospital size, and percent Medicare inpatient days.
Measures of nurse staffing differed in important ways. The differences between the measures were related systematically to ownership, geographic location, teaching status, hospital size, and percentage Medicare inpatient days.
Without an accurate method to incorporate acuity into measurement of nurse staffing, research on the relationship between staffing and quality of care will not reach the full potential to inform practice.
研究护士人员配备与护理质量之间关系的研究人员经常依赖医疗保险病例组合指数来调整患者的病情严重程度，尽管该指数最初是基于医疗诊断制定的，可能无法准确反映患者对护理的需求。
本研究旨在检验未经调整的护士人员配备（每千名调整后患者天的注册护士数）与病例组合调整后的护士人员配备以及使用护理强度权重调整后的护士人员配备之间的差异，这些权重旨在反映患者对护理的需求。
使用了来自 2000 年至 2006 年 13 个州的 579 家医院的二级数据。包括三种护士人员配备指标以及医院特征，包括所有权、地理位置、教学地位、医院规模和医疗保险住院患者比例。
护士人员配备的衡量指标在重要方面存在差异。这些措施之间的差异与所有权、地理位置、教学地位、医院规模和医疗保险住院患者比例存在系统关系。
如果没有一种准确的方法将病情严重程度纳入护士人员配备的测量中，那么关于人员配备与护理质量之间关系的研究将无法充分发挥作用，为实践提供信息。
