美国新生儿重症监护病房中患者病情与护理遗漏的关联。
Association of Patient Acuity and Missed Nursing Care in U.S. Neonatal Intensive Care Units.
机构信息
University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Dartmouth College, Hanover, NH, USA.
出版信息
Med Care Res Rev. 2020 Oct;77(5):451-460. doi: 10.1177/1077558718806743. Epub 2018 Oct 26.
The health outcomes of infants in neonatal intensive care units (NICUs) may be jeopardized when required nursing care is missed. This correlational study of missed care in a U.S. NICU sample adds national scope and an important explanatory variable, patient acuity. Using 2016 NICU registered nurse survey responses ( = 5,861) from the National Database of Nursing Quality Indicators, we found that 36% of nurses missed one or more care activities on the past shift. Missed care prevalence varied widely across units. Nurses with higher workloads, higher acuity assignments, or in poor work environments were more likely to miss care. The most common activities missed involved patient comfort and counseling and parent education. Workloads have increased and work environments have deteriorated compared with 8 years ago. Nurses' assignments should account for patient acuity. NICU nurse staffing and work environments warrant attention to reduce missed care and promote optimal infant and family outcomes.
当需要的护理工作被忽视时，新生儿重症监护病房（NICU）中婴儿的健康结果可能会受到影响。这项在美国 NICU 样本中进行的关于忽视护理的相关性研究增加了国家范围和一个重要的解释变量，即患者病情的严重程度。我们使用了 2016 年国家护理质量指标数据库中 NICU 注册护士调查的回复（n = 5861），发现过去轮班时，有 36%的护士忽视了一项或多项护理活动。忽视护理的发生率在各单位之间差异很大。工作量较大、病情较重或工作环境较差的护士更有可能忽视护理。最常见的忽视的活动涉及患者的舒适、咨询和家长教育。与 8 年前相比，工作量增加了，工作环境也恶化了。护士的工作分配应考虑到患者的病情严重程度。NICU 护士的人员配备和工作环境需要得到关注，以减少忽视护理并促进婴儿和家庭的最佳结果。
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