Barnes Hilary, Rearden Jessica, McHugh Matthew D
Postdoctoral Research Fellow, Center for Health Outcomes and Policy Research University of Pennsylvania School of Nursing, 418 Curie Blvd., Room 388R, Philadelphia, PA, 19104.
Postdoctoral Research Fellow, Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA.
Res Nurs Health. 2016 Apr;39(2):96-104. doi: 10.1002/nur.21709. Epub 2016 Jan 25.
Central-line-associated bloodstream infections (CLABSI) are among the deadliest heathcare-associated infections, with an estimated 12-25% mortality rate. In 2014, the Centers for Medicare and Medicaid Services (CMS) began to penalize hospitals for poor performance with respect to selected hospital-acquired conditions, including CLABSI. A structural factor associated with high-quality nursing care and better patient outcomes is The Magnet Recognition Program®. The purpose of this study was to explore the relationship between Magnet status and hospital CLABSI rates. We used propensity score matching to match Magnet and non-Magnet hospitals with similar hospital characteristics. In a matched sample of 291 Magnet hospitals and 291 non-Magnet hospitals, logistic regression models were used to examine whether there was a link between Magnet status and CLABSI rates. Both before and after matching, Magnet hospital status was associated with better (lower than the national average) CLABSI rates (OR = 1.60, 95%CI: 1.10, 2.33 after matching). While established programs such as Magnet recognition are consistently correlated with high-quality nursing work environments and positive patient outcomes, additional research is needed to determine whether Magnet designation produces positive patient outcomes or rewards existing excellence.
中心静脉导管相关血流感染(CLABSI)是最致命的医疗保健相关感染之一,估计死亡率为12%-25%。2014年,美国医疗保险和医疗补助服务中心(CMS)开始对在包括CLABSI在内的特定医院获得性疾病方面表现不佳的医院进行处罚。与高质量护理和更好的患者预后相关的一个结构因素是磁体认证计划(The Magnet Recognition Program®)。本研究的目的是探讨磁体认证状态与医院CLABSI发生率之间的关系。我们使用倾向得分匹配法,将具有相似医院特征的磁体认证医院和非磁体认证医院进行匹配。在一个由291家磁体认证医院和291家非磁体认证医院组成的匹配样本中,使用逻辑回归模型来检验磁体认证状态与CLABSI发生率之间是否存在关联。在匹配前后,磁体认证医院的状态都与更好(低于全国平均水平)的CLABSI发生率相关(匹配后OR = 1.60,95%CI:1.10,2.33)。虽然诸如磁体认证这样的既定计划一直与高质量的护理工作环境和积极的患者预后相关,但还需要进一步的研究来确定磁体认证是产生了积极的患者预后还是对现有的卓越表现给予了奖励。