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韩国医院中护士休息、护理缺失与患者安全之间的关联。

Association between nurses' breaks, missed nursing care and patient safety in Korean hospitals.

机构信息

Red Cross College of Nursing, Chung-Ang University, Seoul, Korea.

Department of Nursing, Graduate School, Yonsei University, Seoul, Korea.

出版信息

J Nurs Manag. 2020 Nov;28(8):2266-2274. doi: 10.1111/jonm.12831. Epub 2019 Aug 19.

DOI:10.1111/jonm.12831
PMID:31350775
Abstract

AIMS

To examine the relationship between breaks and patient safety in Korean hospitals and determine the mediating effect of missed nursing care on this relationship.

BACKGROUND

Breaks during working hours can affect patient safety; however, few studies have examined the relationship between breaks and patient safety in hospitals and their findings were conflicting.

METHODS

A cross-sectional online survey was conducted with 399 nurses in Korean hospitals. Multiple linear regression was used to explore the association between breaks, missed nursing care and patient safety. Model 4 of Hayes's (2018) and bootstrapping analysis were employed to identify the mediating effect of missed nursing care.

RESULTS

Average break time per shift was about 15 min; most participants had breaks of less than 30 min. Missed nursing care was a complete mediator of the relationship between breaks and patient safety.

CONCLUSION

Break length has an indirect effect on patient safety, medication errors and falls with injury through missed nursing care.

IMPLICATIONS FOR NURSING MANAGEMENT

More discussion is needed to develop policy and mandatory regulations to ensure sufficient breaks and adequate nurse staffing to reduce missed nursing care and enhance patient safety.

摘要

目的

考察韩国医院工作间隙与患者安全的关系,并确定护理差错在其中的中介效应。

背景

工作期间的休息会影响患者安全,但很少有研究调查医院工作间隙与患者安全的关系,且研究结果存在差异。

方法

采用横断面在线调查法,对韩国医院的 399 名护士进行调查。采用多元线性回归分析探讨工作间隙、护理差错与患者安全的关系。采用 Hayes(2018 年)模型 4 和 bootstrap 分析来识别护理差错的中介效应。

结果

平均每班的休息时间约为 15 分钟;大多数参与者的休息时间少于 30 分钟。护理差错完全中介了工作间隙与患者安全之间的关系。

结论

休息时间的长短通过护理差错对患者安全、用药错误和伤害性跌倒产生间接影响。

护理管理意义

需要进一步讨论制定政策和强制性规定,以确保有足够的休息时间和充足的护士人力,减少护理差错,提高患者安全。

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