与护士人员配置指令实施相关的因素

Factors Associated With the Implementation of a Nurse Staffing Directive.

作者信息

Annis Ann M, Robinson Claire H, Yankey Nicholas, Krein Sarah L, Duffy Sonia A, Taylor Beth, Sales Anne

机构信息

Author Affiliations: Postdoctoral Fellow (Dr Annis), Research Health Science Specialist (Ms Robinson and Mr Yankey), Research Career Scientist (Dr Krein), and Research Scientist (Dr Duffy and Dr Sales), Center for Clinical Management Research, VA Ann Arbor Healthcare System, Michigan; Research Professor (Dr Krein), School of Nursing and Department of Internal Medicine, and Professor (Dr Sales), Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor; Professor (Dr Duffy), College of Nursing, Ohio State University, Columbus; and Associate Director for Patient Care Services (Dr Taylor), VA Southern Arizona Health Care System, Tucson.

出版信息

J Nurs Adm. 2017 Dec;47(12):636-644. doi: 10.1097/NNA.0000000000000559.

DOI:10.1097/NNA.0000000000000559

PMID:29135855

Abstract

BACKGROUND

In 2010, the Veterans Health Administration issued a Staffing Methodology (SM) Directive to provide a standardized, data-driven method for determining appropriate inpatient nurse staffing.

OBJECTIVE

We aimed to describe experiences and factors related to SM implementation.

METHODS

We administered a Web-based survey to chief nurse executives to obtain their implementation experiences. Structural, process, and outcome factors and barriers associated with self-reported implementation success were identified.

RESULTS

Respondents representing 104 of 117 facilities participated. Almost all facilities (96%) had completed at least 1 cycle of SM, yet only half (52%) rated their implementation highly successful. Early implementation date, higher levels of leadership confidence in SM, and higher frequency in which nursing staff think in terms of hours per patient day were associated with higher SM implementation success. Time, staff training and educational needs, and engagement were common barriers.

DISCUSSION

Understanding factors that influence successful implementation of staffing policies is important to ensuring safe staffing.

摘要

背景

2010年，退伍军人健康管理局发布了一项人员配置方法（SM）指令，以提供一种标准化的、基于数据的方法来确定适当的住院护士人员配置。

目的

我们旨在描述与SM实施相关的经验和因素。

方法

我们对首席护士执行官进行了一项基于网络的调查，以获取他们的实施经验。确定了与自我报告的实施成功相关的结构、过程和结果因素以及障碍。

结果

代表117个机构中的104个机构的受访者参与了调查。几乎所有机构（96%）都完成了至少1个SM周期，但只有一半（52%）将其实施评为非常成功。早期实施日期、领导层对SM的信心水平较高以及护理人员按每天每位患者的小时数进行思考的频率较高与较高的SM实施成功率相关。时间、员工培训和教育需求以及参与度是常见的障碍。