Escobar-Aguilar Gema, Gómez-García Teresa, Ignacio-García Emilio, Rodríguez-Escobar José, Moreno-Casbas Teresa, Fuentelsaz-Gallego Carmen, González-María Esther, Contreras-Moreira Mónica
Unidad de Investigación en Cuidados de Salud Investén-ISCIII, Instituto de Salud Carlos III, Madrid, España.
Enferm Clin. 2013 May-Jun;23(3):103-13. doi: 10.1016/j.enfcli.2013.03.005. Epub 2013 May 4.
To analyze the relationship between the work environment and burnout of nurses and the quality of care for patient safety at the Spanish National Health System Hospitals included in SENECA and RN4CAST studies.
Descriptive study with a secondary analysis that compares data of 984 patient records, 1469 patient, and 1886 professional surveys from SENECA project, with 2139 nurses' surveys from RN4CAST study, in 24 hospitals. Adverse events data related to care, and patient's and professional's perception of safety were compared with work environment (measured by the Nursing Work Index) and burnout (measured by Maslach Burnout Inventory).
There was a statistically significant relation of pain with «Staffing and resource adequacy» (r=-0,435, p=0,03) and nosocomial infection with «Nursing foundations for quality of care» (r=-0,424; p=0,04) and «Nurse participation in hospital affairs» (r=-0,516, p=0,01) of the Nursing Work Index. The hospital classification obtained from the Nursing Work Index was associated with the patients' perception of safety (r=0,66, p<0,01). Professionals' perception of participation in patient safety issues was associated with the five factors of the Nursing Work Index (r ∈ [|0,41|-|0,78 |], p<0,046) and with Maslach emotional exhaustion (r=-0,518, p=0,01).
The organizations that foster a supportive work environment will have patients that perceive safer care. In addition, proper resource management could decrease the occurrence of adverse events such as pain.
分析西班牙国家卫生系统医院中护士的工作环境与职业倦怠之间的关系，以及对患者安全护理质量的影响。这些医院参与了SENECA和RN4CAST研究。
描述性研究，并进行二次分析，比较了来自SENECA项目的984份患者记录、1469名患者和1886份专业调查问卷的数据，以及来自RN4CAST研究的24家医院的2139名护士的调查问卷数据。将与护理相关的不良事件数据、患者和专业人员对安全的认知与工作环境（通过护理工作指数衡量）和职业倦怠（通过马氏职业倦怠量表衡量）进行比较。
疼痛与护理工作指数中的“人员配备和资源充足性”存在统计学显著关系（r = -0.435，p = 0.03），医院感染与“护理质量基础”（r = -0.424；p = 0.04）和“护士参与医院事务”（r = -0.516，p = 0.01）存在统计学显著关系。从护理工作指数获得的医院分类与患者对安全的认知相关（r = 0.66，p < 0.01）。专业人员对参与患者安全问题的认知与护理工作指数的五个因素相关（r ∈ [|0.41|-|0.78 |]，p < 0.046），并与马氏情感耗竭相关（r = -0.518，p = 0.01）。
营造支持性工作环境的组织会让患者感觉到护理更安全。此外，合理的资源管理可以减少疼痛等不良事件的发生。
