国家质量论坛安全实践在磁性医院的采用。
Adoption of national quality forum safe practices by Magnet® hospitals.
机构信息
College of Public Health, University of Georgia, Health Policy and Management, 110 E Clayton St, Suite 300, Athens, GA 30602-7396, USA.
出版信息
J Nurs Adm. 2012 Oct;42(10 Suppl):S37-43. doi: 10.1097/01.NNA.0000420393.41155.03.
BACKGROUND
Magnet® hospitals (MHs) are known for their high retention rates of nurses and positive work environment, yet little is known about whether MHs also have higher levels of safe practice adoption rates compared with non-Magnet hospitals (NMHs).
METHODS
In this study, we investigate adoption of National Quality Forum (NQF) Safe Practices in 34 regions during 2004 to 2006 that were part of the Leapfrog Group initiative to improve quality of hospital care. We conducted a secondary data analysis by combining multiple data sets from the American Hospital Association Annual Survey,Healthcare Cost Reports Information System, and Leapfrog Group Annual Hospital Survey. A composite safe practice score (CSPS) was constructed from the Leapfrog annual survey and ranged from 0 (no adoption) to 1,000 (complete adoption) of the 30 NQF Safe Practices. A descriptive analysis and a regression with Heckman correction to control for selection bias were used to determine the effect of Magnet status and other hospital and market characteristics on differences in CSPS over the 3-year period.
RESULTS
There were 140 MHs and 1,320 NMHs reporting data for the CSPS. In 2004, MHs had a mean CSPS of 865 versus 774 for NMHs (P < .001). By 2006, NMHs improved their CSPS from 774 to 872 (98 points), whereas MHs improved their CSPS from 865 to 925 (60 points, P < .001). Regression analysis showed a positive and significant effect of Magnet status of hospitals on the adoption rates of NQF Safe Practices as measured by the CSPS. Our results also indicated that smaller hospitals (in bed size), hospitals with larger share of Medicare patients, higher nurse intensity levels (mean hours of nursing care per day), and higher levels of competition among hospitals in Leapfrog rollout regions were associated with higher CSPS.
CONCLUSION
Magnet hospitals in the urban areas of 34 Leapfrog rollout regions were more likely to have higher adoption rates of NQF Safe Practices in comparison to NMHs in the same demographic areas during the time frame of the study, but other hospitals nearly closed the gap by 2006.
背景
Magnet® 医院（MHs）以其护士高留存率和积极的工作环境而闻名，但几乎不知道与非 Magnet 医院（NMHs）相比，MHs 是否也具有更高水平的安全实践采用率。
方法
在这项研究中，我们调查了 2004 年至 2006 年期间，34 个地区采用国家质量论坛（NQF）安全实践的情况，这些地区是 Leapfrog 集团提高医院护理质量倡议的一部分。我们通过结合美国医院协会年度调查、医疗保健成本报告信息系统和 Leapfrog 集团年度医院调查的多个数据集进行了二次数据分析。从 Leapfrog 年度调查中构建了一个综合安全实践得分（CSPS），范围从 30 个 NQF 安全实践中的 0（未采用）到 1000（完全采用）。使用描述性分析和带有 Hechman 校正的回归来控制选择偏差，以确定 Magnet 状态和其他医院和市场特征对 3 年期间 CSPS 差异的影响。
结果
有 140 家 MHs 和 1320 家 NMHs 报告了 CSPS 数据。2004 年，MHs 的平均 CSPS 为 865，而 NMHs 为 774（P <.001）。到 2006 年，NMHs 将其 CSPS 从 774 提高到 872（98 分），而 MHs 将其 CSPS 从 865 提高到 925（60 分，P <.001）。回归分析显示，医院的 Magnet 状态对 NQF 安全实践的采用率具有积极而显著的影响，这是通过 CSPS 衡量的。我们的结果还表明，较小的医院（床位规模）、 Medicare 患者比例较大的医院、护士强度水平较高（每天护理时间的平均小时数）以及在 Leapfrog 推广地区医院之间竞争水平较高的医院与较高的 CSPS 相关。
结论
在研究期间，与同一人口统计学地区的 NMHs 相比，34 个 Leapfrog 推广地区的城市地区的 Magnet 医院更有可能采用 NQF 安全实践，但到 2006 年，其他医院几乎缩小了差距。
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