Chang Chih-Lun, Tang Gau-Jun, Wu Chin-Pyng, Pu Christy, Chen Hsin-Chih
Department of Critical Care Medicine, Landseed Hospital, Taoyuan, Taiwan.
Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
J Am Assoc Nurse Pract. 2020 Mar;32(3):252-260. doi: 10.1097/JXX.0000000000000275.
In Taiwan, nurse practitioners (NPs) have taken on expanded clinical roles in the intensive care unit (ICU) due to insufficient staffing of attending physicians and resident physicians.
The objective of this study was to investigate the influence of NP staffing on the quality of patient care in ICUs.
This is a retrospective study that selected patients from the ICUs of three hospitals during 2015. The mortality risks among the three hospitals were compared after adjusting variables using the Cox regression model. The care qualities of the three hospitals were analyzed using the standardized mortality ratio.
Hospital A consisted of attending physicians and resident physicians. Hospital B consisted of attending physicians and NPs. Hospital C consisted of attending physicians, NPs, and resident physicians.
Outcomes were assessed for 2,932 patients. The patients in hospital A had a lower mortality risk than hospital B or C. Septic shock patients received better care quality in hospital B than in hospital A or hospital C.
In regional hospitals with lower NP-to-patient ratios, increasing that ratio could reduce the risk of mortality in the ICU and increase the quality of care.
在台湾，由于主治医师和住院医师人员配备不足，执业护士（NPs）在重症监护病房（ICU）承担了更多的临床职责。
本研究的目的是调查重症监护病房中执业护士人员配备对患者护理质量的影响。
这是一项回顾性研究，选取了2015年期间三家医院重症监护病房的患者。使用Cox回归模型对变量进行调整后，比较了三家医院的死亡风险。使用标准化死亡率分析了三家医院的护理质量。
医院A由主治医师和住院医师组成。医院B由主治医师和执业护士组成。医院C由主治医师、执业护士和住院医师组成。
对2932例患者的结果进行了评估。医院A的患者死亡风险低于医院B或C。感染性休克患者在医院B接受的护理质量优于医院A或医院C。
在执业护士与患者比例较低的地区医院，提高该比例可降低重症监护病房的死亡风险并提高护理质量。
