School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia.
J Adv Nurs. 2012 Dec;68(12):2710-8. doi: 10.1111/j.1365-2648.2012.05971.x. Epub 2012 Mar 4.
This article is a report of a study of the association between skill mix and 14 nursing-sensitive outcomes following implementation of the nursing hours per patient day staffing method in Western Australian public hospitals in 2002, which determined nursing hours by ward category but not skill mix.
Findings from previous studies indicate that higher nurse staffing levels and a richer skill mix are associated with improved patient outcomes. Measuring skill mix at a hospital level for specific staffing methods and associated nursing-sensitive patient outcomes are important in providing staffing for optimal patient care.
The research design for the larger study was retrospectively analysing patient and staffing administrative data from three adult tertiary hospitals in metropolitan Perth over 4 years.
A subset of data was used to determine the impact of skill mix on nursing-sensitive outcomes following implementation of the staffing method. All patient records (N=103,330) and nurse staffing records (N=73,770) from nursing hours per patient day wards from October 2002-June 2004 following implementation were included.
Increases in Registered Nurse hours were associated with important decreases in eight nursing-sensitive outcomes at hospital level and increases in three nursing-sensitive outcomes. The lowest skill mix saw the greatest reduction in nursing-sensitive outcome rates.
The skill mix of nurses providing care could impact patient outcomes and is an important consideration in strategies to improve nurse staffing. Levels of hospital nurse staffing and skill mix are important organizational characteristics when predicting patient outcomes.
本文是对 2002 年西澳公立医院实施按患者护理日每小时护理人员配备方法后，护理人员配备方法按病房类别而非技能混合来确定护理人员数量的情况下，技能混合与 14 项护理敏感结局之间关联的研究报告。
先前研究的结果表明，更高的护理人员配备水平和更丰富的技能组合与改善患者结局相关。对于特定的人员配备方法和相关的护理敏感患者结局，在医院层面上衡量技能组合对于提供最佳患者护理的人员配备非常重要。
更大规模研究的研究设计是对珀斯市区的三家成人三级医院 4 年来的患者和人员配备行政数据进行回顾性分析。
使用数据集的一个子集来确定在实施人员配备方法后，技能组合对护理敏感结局的影响。包括 2002 年 10 月至 2004 年 6 月期间，按患者护理日每小时护理人员配备方法的病房的所有患者记录（N=103330）和护理人员配备记录（N=73770）。
注册护士工作时间的增加与医院层面上 8 项重要护理敏感结局的重要下降以及 3 项护理敏感结局的增加相关。技能组合最低的护理人员看到了护理敏感结局率的最大降低。
提供护理的护士的技能组合可能会影响患者的结局，并且在改善护理人员配备的策略中是一个重要的考虑因素。医院护士配备水平和技能组合是预测患者结局的重要组织特征。
