University of Pennsylvania, Philadelphia, PA 19104, USA.
J Nurs Scholarsh. 2011 Sep;43(3):301-10. doi: 10.1111/j.1547-5069.2011.01403.x. Epub 2011 Jul 25.
To examine the influence of nursing-specifically nurse staffing and the nurse work environment-on quality of care and patient satisfaction in hospitals with varying concentrations of Black patients.
Cross-sectional secondary analysis of 2006-2007 nurse survey data collected across four states (Florida, Pennsylvania, New Jersey, and California), the Hospital Consumer Assessment of Healthcare Providers and Systems survey, and administrative data. Global analysis of variance and linear regression models were used to examine the association between the concentration of Black patients on quality measures (readiness for discharge, patient or family complaints, health care-associated infections) and patient satisfaction, before and after accounting for nursing and hospital characteristics.
Nurses working in hospitals with higher concentrations of Blacks reported poorer confidence in patients' readiness for discharge and more frequent complaints and infections. Patients treated in hospitals with higher concentrations of Blacks were less satisfied with their care. In the fully adjusted regression models for quality and patient satisfaction outcomes, the effects associated with the concentration of Blacks were explained in part by nursing and structural hospital characteristics.
This study demonstrates a relationship between nursing, structural hospital characteristics, quality of care, and patient satisfaction in hospitals with high concentrations of Black patients.
Consideration of nursing factors, in addition to other important hospital characteristics, is critical to understanding and improving quality of care and patient satisfaction in minority-serving hospitals.
研究护理专业人员配置和护理工作环境对不同比例黑人员工的医院的护理质量和患者满意度的影响。
对四个州（佛罗里达州、宾夕法尼亚州、新泽西州和加利福尼亚州）2006-2007 年护士调查数据、医院消费者评估医疗保健提供者和系统调查以及行政数据进行的跨部门二次分析。采用全局方差分析和线性回归模型，在考虑护理和医院特征之前和之后，检查黑人员工比例与质量措施（出院准备情况、患者或家属投诉、医疗相关感染）和患者满意度之间的关联。
在黑人比例较高的医院工作的护士报告对患者出院准备情况的信心较低，投诉和感染的频率较高。在黑人比例较高的医院接受治疗的患者对其护理的满意度较低。在质量和患者满意度结果的完全调整回归模型中，与黑人比例相关的影响部分由护理和结构性医院特征解释。
这项研究表明，在黑人比例较高的医院中，护理、结构性医院特征、护理质量和患者满意度之间存在关系。
除了其他重要的医院特征外，考虑护理因素对于理解和改善少数民族服务医院的护理质量和患者满意度至关重要。
