St Luke's University Health Network, Quakertown, Pennsylvania 18951, USA.
J Nurs Adm. 2013 Sep;43(9):455-60. doi: 10.1097/NNA.0b013e3182a23b9b.
This study examined the effects of an acuity-adaptable care model in a rural hospital setting on nurse satisfaction, patient satisfaction, patient safety, and quality indicators (events, falls, and medication errors), patient length of stay (LOS), and worked hours per patient-day (WHPPD).
Acuity-adaptable care models have been implemented as a nursing strategy to improve workflow through the elimination of unit-to-unit patient handoffs. However, to our knowledge, this model of care has not been studied in a rural hospital setting.
A descriptive, comparative design with repeated measures was utilized for this study. A professional nurse survey was created to measure staff satisfaction; separate t tests for percentages were utilized to evaluate patient satisfaction and patient safety/quality indicators. Financial data were examined to perform the analysis of patient LOS and WHPPD.
The nurse satisfaction survey demonstrated a decrease in weekly floating and cancellations due to low census. There was a statistically significant improvement in patient satisfaction for overall rating and willingness to recommend the hospital. No significant difference was noted in patient quality indicators or LOS; however, there was a favorable trend for all events and medication errors. This study also found a decrease in WHPPD, with a corresponding salary expense reduction reported.
Acuity-adaptable units may be a viable strategy for rural facilities.
本研究考察了农村医院环境中适应敏锐度的护理模式对护士满意度、患者满意度、患者安全和质量指标（事件、跌倒和用药错误）、患者住院时间（LOS）和每位患者每天工作时间（WHPPD）的影响。
适应敏锐度的护理模式已作为一种护理策略实施，通过消除单元间的患者交接来改善工作流程。然而，据我们所知，这种护理模式尚未在农村医院环境中进行研究。
本研究采用描述性、比较性设计和重复测量方法。创建了一份专业护士调查，以衡量员工满意度；采用百分比的独立 t 检验来评估患者满意度和患者安全/质量指标。对财务数据进行了检查，以分析患者 LOS 和 WHPPD。
护士满意度调查显示，由于低患者人数，每周浮动和取消的情况有所减少。患者总体评价和推荐医院的意愿方面的满意度有显著提高。患者质量指标或 LOS 没有显著差异；然而，所有事件和用药错误都有有利的趋势。本研究还发现每位患者每天工作时间减少，同时报告工资支出减少。
适应敏锐度单元可能是农村设施的可行策略。
