Pitkäaho Taina, Partanen Pirjo, Miettinen Merja H, Vehviläinen-Julkunen Katri
Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
Kuopio University Hospital, Kuopio, Finland.
J Nurs Manag. 2016 Jul;24(5):571-9. doi: 10.1111/jonm.12359. Epub 2016 Feb 1.
To examine the relationship between nurse staffing and patient length of stay in an acute-care hospital over a 1-year period.
Although there has been prior research on the relationship between nurse staffing and length of stay in acute-care hospitals, there is a need for more information on how nurse staffing is related to length of stay longitudinally.
Retrospective time-series registry data from 20 acute-care inpatient units of a Finnish university hospital as a monthly time series in 2008 were analysed by linear mixed models.
The ratio of registered nurses to all nurses was 72.4%. Nurses worked mainly (96%) full time, and 63% had permanent employment contracts. Statistically significant variation was found in time series of five variables. Statistically significant relationships were found between length of stay and patient acuity, diagnosis-related group-volume, census and nursing hours per patient day at the unit level. Nursing hours per patient day had the strongest correlation with length of stay.
A rational response to the variations in patient care needs and intensity in the complex care environment is flexible nurse staffing. Increasing nursing hours per patient day to achieve shorter length of stays is not the only solution, well-functioning care processes are also essential.
研究一家急症护理医院在1年期间护士配备与患者住院时间之间的关系。
尽管此前已有关于急症护理医院护士配备与住院时间关系的研究，但仍需要更多关于护士配备如何与住院时间纵向相关的信息。
采用线性混合模型分析了芬兰一家大学医院20个急症护理住院单元2008年按月时间序列的回顾性时间序列登记数据。
注册护士与所有护士的比例为72.4%。护士主要（96%）全职工作，63%签订了长期雇佣合同。在五个变量的时间序列中发现了具有统计学意义的差异。在单元层面，住院时间与患者病情严重程度、诊断相关组数量、普查人数和每日每位患者护理时长之间存在具有统计学意义的关系。每日每位患者护理时长与住院时间的相关性最强。
在复杂的护理环境中，对患者护理需求和强度变化的合理应对措施是灵活的护士配备。增加每日每位患者护理时长以缩短住院时间并非唯一解决方案，良好运行的护理流程同样至关重要。
