Boyle Diane K, Bergquist-Beringer Sandra, Cramer Emily
Diane K. Boyle, PhD, RN, FAAN, Fay W. Whitney School of Nursing, University of Wyoming, Laramie. Sandra Bergquist-Beringer, PhD, RN, CWCN, School of Nursing, University of Kansas Medical Center, Kansas City. Emily Cramer, PhD, School of Nursing, University of Kansas Medical Center, Kansas City.
J Wound Ostomy Continence Nurs. 2017 May/Jun;44(3):283-292. doi: 10.1097/WON.0000000000000327.
The purpose of this study was to describe the (a) number and types of employed WOC certified nurses in acute care hospitals, (b) rates of hospital-acquired pressure injury (HAPI) and catheter-associated urinary tract infection (CAUTI), and (c) effectiveness of WOC certified nurses with respect to lowering HAPI and CAUTI occurrences.
Retrospective analysis of data from National Database of Nursing Quality Indicators.
The sample comprised 928 National Database of Nursing Quality Indicators (NDNQI) hospitals that participated in the 2012 NDNQI RN Survey (source of specialty certification data) and collected HAPI, CAUTI, and nurse staffing data during the years 2012 to 2013.
We analyzed years 2012 to 2013 data from the NDNQI. Descriptive statistics summarized the number and types of employed WOC certified nurses, the rate of HAPI and CAUTI, and HAPI risk assessment and prevention intervention rates. Chi-square analyses were used to compare the characteristics of hospitals that do and do not employ WOC certified nurses. Analysis-of-covariance models were used to test the association between WOC certified nurses and HAPI and CAUTI occurrences.
Just more than one-third of the study hospitals (36.6%) employed WOC certified nurses. Certified continence care nurses (CCCNs) were employed in fewest number. Hospitals employing wound care specialty certified nurses (CWOCN, CWCN, and CWON) had lower HAPI rates and better pressure injury risk assessment and prevention practices. Stage 3 and 4 HAPI occurrences among hospitals employing CWOCNs, CWCNs, and CWONs (0.27%) were nearly half the rate of hospitals not employing these nurses (0.51%). There were no significant relationships between nurses with specialty certification in continence care (CWOCN, CCCN) or ostomy care (CWOCN, COCN) and CAUTI rates.
CWOCNs, CWCNs, and CWONs are an important factor in achieving better HAPI outcomes in acute care settings. The role of CWOCNs, CCCNs, and COCNs in CAUTI prevention warrants further investigation.
本研究旨在描述（a）急症医院中受雇的伤口造口失禁专科认证护士的数量和类型，（b）医院获得性压疮（HAPI）和导尿管相关尿路感染（CAUTI）的发生率，以及（c）伤口造口失禁专科认证护士在降低HAPI和CAUTI发生率方面的有效性。
对国家护理质量指标数据库中的数据进行回顾性分析。
样本包括928家参与2012年国家护理质量指标数据库（NDNQI）注册护士调查（专业认证数据来源）并在2012年至2013年期间收集HAPI、CAUTI和护士人员配置数据的医院。
我们分析了NDNQI 2012年至2013年的数据。描述性统计总结了受雇的伤口造口失禁专科认证护士的数量和类型、HAPI和CAUTI的发生率以及HAPI风险评估和预防干预率。采用卡方分析比较聘用和未聘用伤口造口失禁专科认证护士的医院的特征。协方差分析模型用于检验伤口造口失禁专科认证护士与HAPI和CAUTI发生率之间的关联。
略多于三分之一的研究医院（36.6%）聘用了伤口造口失禁专科认证护士。聘用的认证失禁护理护士（CCCN）数量最少。聘用伤口护理专科认证护士（CWOCN、CWCN和CWON）的医院HAPI发生率较低，且压疮风险评估和预防措施更好。聘用CWOCN、CWCN和CWON的医院中3期和4期HAPI发生率（0.27%）几乎是未聘用这些护士的医院发生率（0.51%）的一半。失禁护理（CWOCN、CCCN）或造口护理（CWOCN、COCN）专科认证护士与CAUTI发生率之间无显著关系。
CWOCN、CWCN和CWON是在急症护理环境中实现更好的HAPI结果的重要因素。CWOCN、CCCN和COCN在预防CAUTI方面的作用值得进一步研究。
