Gkantaras Ioannis, Mahfoud Ziyad R, Foreman Brent, Thompson David R, Cannaby Ann Marie, Deshpande Deepak Hanmanthrao, Watson Roger, Topping Annie, Gray Richard
Hamad Medical Corporation, Doha, Qatar.
Weill Cornell Medical College, Doha, Qatar.
J Adv Nurs. 2016 Dec;72(12):3034-3044. doi: 10.1111/jan.13059. Epub 2016 Jul 27.
To investigate the relationship between patient mortality and the educational preparation (graduateness) of the nurses who cared for them.
There have been 18 studies over the last two decades examining the effect of nurses' educational qualifications on mortality. All but three have used mortality data aggregated at the hospital level that has been combined with surveys of nurses to estimate the level of graduateness in the population. Data collection and extraction generally has been done at different points in time.
A retrospective, cross-sectional study.
Routine administrative patient data were extracted (May-August 2015). The primary outcome was all-cause patient mortality at discharge. We were able to identify the individual nurses who provided care during patients inpatient stay using an identification number. We were then able to calculate the 'graduateness' of the nursing care patients received by dividing the number of recorded episodes of care provided by baccalaureate prepared nurses with the total number of care episodes.
After adjusting for confounding, we observed a significant association between patient mortality and nurse graduateness. Our observations suggest an optimum level of baccalaureate prepared nurses of approximately 70%. Above this level, there appears to be no additional decrease in mortality rates.
This study represents an important methodological step forward over previous approaches. Our observations are generally consistent with existing literature and confirm the importance of baccalaureate nurse education.
探讨患者死亡率与护理他们的护士的教育程度（毕业率）之间的关系。
在过去二十年中，有18项研究考察了护士的教育资质对死亡率的影响。除三项研究外，其余所有研究均使用了医院层面汇总的死亡率数据，并结合护士调查来估计总体中的毕业率水平。数据收集和提取通常在不同时间点进行。
一项回顾性横断面研究。
提取常规管理的患者数据（2015年5月至8月）。主要结局是出院时的全因患者死亡率。我们能够使用识别码确定在患者住院期间提供护理的个体护士。然后，通过将获得学士学位的护士提供的记录护理事件数除以护理事件总数，我们能够计算患者接受的护理的“毕业率”。
在对混杂因素进行调整后，我们观察到患者死亡率与护士毕业率之间存在显著关联。我们的观察结果表明，获得学士学位的护士的最佳比例约为70%。高于此水平，死亡率似乎没有进一步下降。
本研究代表了比以往方法在方法学上向前迈出的重要一步。我们的观察结果总体上与现有文献一致，并证实了学士学位护士教育的重要性。
