Center for Health Outcomes and Policy Research, University of Pennsylvania, 418 Curie Blvd., Philadelphia, PA 19104-4217, USA.
Int J Qual Health Care. 2011 Aug;23(4):357-64. doi: 10.1093/intqhc/mzr022. Epub 2011 May 11.
To determine the effect of hospital work environments on hospital outcomes across multiple countries.
Primary survey data using a common instrument were collected from separate cross sections of 98 116 bedside care nurses practising in 1406 hospitals in 9 countries between 1999 and 2009.
Nurse burnout and job dissatisfaction, patient readiness for hospital discharge and quality of patient care.
High nurse burnout was found in hospitals in all countries except Germany, and ranged from roughly a third of nurses to about 60% of nurses in South Korea and Japan. Job dissatisfaction among nurses was close to 20% in most countries and as high as 60% in Japan. Close to half or more of nurses in every country lacked confidence that patients could care for themselves following discharge. Quality-of-care rated as fair or poor varied from 11% in Canada to 68% in South Korea. Between one-quarter and one-third of hospitals in each country were judged to have poor work environments. Working in a hospital with a better work environment was associated with significantly lower odds of nurse burnout and job dissatisfaction and with better quality-of-care outcomes.
Poor hospital work environments are common and are associated with negative outcomes for nurses and quality of care. Improving work environments holds promise for nurse retention and better quality of patient care.
确定医院工作环境对多个国家医院结果的影响。
1999 年至 2009 年间，在 9 个国家的 1406 家医院中，对 98116 名从事床边护理的护士进行了一项常见工具的横断面调查，收集了初步调查数据。
护士倦怠和工作不满、患者准备出院和患者护理质量。
除德国外，所有国家的医院护士倦怠率都很高，从大约三分之一的护士到韩国和日本约 60%的护士。大多数国家的护士工作不满率接近 20%，日本高达 60%。几乎一半或更多的护士在每个国家都缺乏对患者出院后自我护理能力的信心。护理质量评定为一般或较差，加拿大为 11%，韩国为 68%。每个国家四分之一到三分之一的医院被认为工作环境较差。在工作环境较好的医院工作与护士倦怠和工作不满的几率显著降低以及护理质量更好有关。
较差的医院工作环境很常见，并与护士和护理质量的不良结果相关。改善工作环境有望留住护士并提高患者护理质量。
