注册护士倦怠、工作不满和养老院护理缺失。
Registered Nurse Burnout, Job Dissatisfaction, and Missed Care in Nursing Homes.
机构信息
Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania.
出版信息
J Am Geriatr Soc. 2019 Oct;67(10):2065-2071. doi: 10.1111/jgs.16051. Epub 2019 Jul 23.
OBJECTIVES
To examine the relationship between registered nurse (RN) burnout, job dissatisfaction, and missed care in nursing homes.
DESIGN
Cross-sectional secondary analysis of linked data from the 2015 RN4CAST-US nurse survey and LTCfocus.
SETTING
A total of 540 Medicare- and Medicaid-certified nursing homes in California, Florida, New Jersey, and Pennsylvania.
PARTICIPANTS
A total of 687 direct care RNs.
MEASUREMENTS
Emotional Exhaustion subscale of the Maslach Burnout Inventory, job dissatisfaction, and missed care.
RESULTS
Across all RNs, 30% exhibited high levels of burnout, 31% were dissatisfied with their job, and 72% reported missing one or more necessary care tasks on their last shift due to lack of time or resources. One in five RNs reported frequently being unable to complete necessary patient care. Controlling for RN and nursing home characteristics, RNs with burnout were five times more likely to leave necessary care undone (odds ratio [OR] = 4.97; 95% confidence interval [CI] = 2.56-9.66) than RNs without burnout. RNs who were dissatisfied were 2.6 times more likely to leave necessary care undone (OR = 2.56; 95% CI = 1.68-3.91) than RNs who were satisfied. Tasks most often left undone were comforting/talking with patients, providing adequate patient surveillance, patient/family teaching, and care planning.
CONCLUSION
Missed nursing care due to inadequate time or resources is common in nursing homes and is associated with RN burnout and job dissatisfaction. Improved work environments with sufficient staff hold promise for improving care and nurse retention. J Am Geriatr Soc 67:2065-2071, 2019.
目的
研究注册护士（RN）倦怠、工作不满与疗养院护理缺失之间的关系。
设计
对 2015 年 RN4CAST-US 护士调查和 LTCfocus 的链接数据进行横断面二次分析。
地点
加利福尼亚、佛罗里达、新泽西和宾夕法尼亚州的 540 家经医疗保险和医疗补助认证的疗养院。
参与者
共 687 名直接护理 RN。
测量方法
采用 Maslach 倦怠量表的情绪衰竭分量表、工作不满和护理缺失。
结果
在所有 RN 中，30%的人表现出高度倦怠，31%的人对工作不满，72%的人报告在上次轮班时因缺乏时间或资源而遗漏了一项或多项必要的护理任务。五分之一的 RN 报告经常无法完成必要的患者护理。在控制 RN 和疗养院特征后，倦怠的 RN 未完成必要护理的可能性是未倦怠 RN 的五倍（比值比[OR] = 4.97；95%置信区间[CI] = 2.56-9.66）。对工作不满的 RN 未完成必要护理的可能性是对工作满意的 RN 的 2.6 倍（OR = 2.56；95% CI = 1.68-3.91）。最常遗漏的任务是安慰/与患者交谈、提供充分的患者监测、患者/家属教育和护理计划。
结论
疗养院中由于时间或资源不足导致的护理缺失较为常见，与 RN 倦怠和工作不满有关。改善工作环境，增加充足的员工数量有望改善护理和护士留用率。美国老年学会杂志 67:2065-2071, 2019。
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