Stalpers Dewi, van der Linden Dimitri, Kaljouw Marian J, Schuurmans Marieke J
Dewi Stalpers, MSc, is a RN-ICU, St. Antonius Hospital and PhD Student, University of Utrecht, The Netherlands. Dimitri van der Linden, PhD, is Associate Professor, Institute of Psychology, Erasmus University, Rotterdam, The Netherlands. Marian J. Kaljouw, PhD, is Chief Executive Officer, Dutch Healthcare Authority, Utrecht, The Netherlands. Marieke J. Schuurmans, PhD, is Professor, Department of Revalidation Nursing Science & Sports, University Medical Centre Utrecht, The Netherlands.
Nurs Res. 2016 Sep-Oct;65(5):362-70. doi: 10.1097/NNR.0000000000000170.
Deliberate screening allows detection of health risks that are otherwise not noticeable and allows expedient intervention to minimize complications and optimize outcomes, especially during critical events like hospitalization. Little research has evaluated the usefulness of screening performance and outcome indicators as measures to differentiate nursing quality, although policymakers are using them to benchmark hospitals.
The aims of this study were to examine hospital performance based on nursing-sensitive screening indicators and to assess associations with hospital characteristics and nursing-sensitive outcomes for patients.
A secondary use of nursing-sensitive data from the Dutch Health Care Inspectorate was performed, including the mandatory screening and outcome indicators related to delirium, malnutrition, pain and pressure ulcers. The sample consisted of all 93 hospitals in the Netherlands in 2011. High- and low-performing hospitals were determined based on the overall proportion of screened patients. Descriptive statistics and analysis of variance were used to examine screening performances in relation to hospital characteristics and nursing-sensitive outcomes.
Over all hospitals, the average screening rates ranged from 59% (delirium) to 94% (pain). Organizational characteristics were not different in high- and low-performing hospitals. The hospitals with the best overall screening performances had significantly better results regarding protein intake within malnourished patients (p < .01). For mortality, marginal significant effects did not remain after controlling for organizational structures. No associations were found with prevalence of pressure ulcers and patient self-reported pain scores.
The screening for patient risks is an important nursing task. Our findings suggest that nursing-sensitive screening indicators may be relevant measures for benchmarking nursing quality in hospitals. Time-trend studies are required to support our findings and to further investigate relations with nursing-sensitive outcomes.
蓄意筛查能够发现那些在其他情况下不易察觉的健康风险，并能进行及时干预，以将并发症降至最低并优化治疗效果，尤其是在住院等关键事件期间。尽管政策制定者将筛查绩效和结果指标用作医院的基准，但很少有研究评估这些指标作为区分护理质量的手段的有用性。
本研究的目的是基于护理敏感筛查指标检查医院绩效，并评估与医院特征和患者护理敏感结果的关联。
对荷兰医疗保健检查局的护理敏感数据进行二次分析，包括与谵妄、营养不良、疼痛和压疮相关的强制性筛查和结果指标。样本包括2011年荷兰的所有93家医院。根据筛查患者的总体比例确定表现高和低的医院。使用描述性统计和方差分析来检查与医院特征和护理敏感结果相关的筛查绩效。
在所有医院中，平均筛查率从59%（谵妄）到94%（疼痛）不等。表现高和低的医院的组织特征没有差异。总体筛查表现最佳的医院在营养不良患者的蛋白质摄入量方面有显著更好的结果（p < 0.01）。对于死亡率，在控制组织结构后，边缘显著效应不再存在。未发现与压疮患病率和患者自我报告的疼痛评分有相关性。
对患者风险进行筛查是一项重要的护理任务。我们的研究结果表明，护理敏感筛查指标可能是衡量医院护理质量的相关指标。需要进行时间趋势研究来支持我们的研究结果，并进一步调查与护理敏感结果的关系。
Zotero 插件