Amiri Arshia, Solankallio-Vahteri Tytti, Tuomi Sirpa
JAMK University of Applied Sciences, Jyväskylä, Finland.
Int J Nurs Sci. 2019 May 23;6(3):239-246. doi: 10.1016/j.ijnss.2019.05.003. eCollection 2019 Jul 10.
To analyze the role of nurse staffing in improving patient safety due to reducing surgical complications in member countries of Organization for Economic Co-operation and Development (OECD).
The number of practicing nurses' density per 1000 population and five surgical complications indicators including foreign body left in during procedure (FBL), postoperative pulmonary embolism (PPE) and deep vein thrombosis (DVT) after hip and knee replacement, postoperative sepsis after abdominal surgery (PSA) and postoperative wound dehiscence (PWD) were collected in crude rates per 100,000 hospital discharges for age group of 15 years old and over within 30 days after surgery based on surgical admission-related and all admission-related methods. The observations of 21 OECD countries were collected from OECD Health Statistics during 2010-2015 period. The statistical technique of panel data analysis including unit root test, co-integration test and dynamic long-run analysis were used to estimate the possible relationship between our panel series.
There were significant relationships from nurse-staffing level to reducing FBL, PPE, DVT, PSA and PWD with long-run magnitudes of -2.91, -1.30, -1.69, -2.81 and -1.12 based on surgical admission method as well as -6.12, -14.57, -7.29, -1.41 and -0.88 based on all admission method, respectively.
A higher proportion of nurses is associated with higher patient safety resulting from lower surgical complications and adverse clinical outcomes in OECD countries. Hence, we alert policy makers about the risk of underestimating the impact of nurses on improving patient safety as well as the quality of health care services in OECD countries.
分析经济合作与发展组织（OECD）成员国中护士配备在降低手术并发症以提高患者安全方面的作用。
基于手术入院相关和所有入院相关方法，收集了每1000人口中执业护士的密度以及五个手术并发症指标，包括手术过程中遗留异物（FBL）、术后肺栓塞（PPE）、髋膝关节置换术后深静脉血栓形成（DVT）、腹部手术后术后败血症（PSA）和术后伤口裂开（PWD），以每10万例15岁及以上年龄组手术后30天内出院患者的粗发病率表示。2010 - 2015年期间从经合组织卫生统计数据中收集了21个经合组织国家的观察数据。采用面板数据分析的统计技术，包括单位根检验、协整检验和动态长期分析，来估计我们的面板序列之间可能的关系。
基于手术入院方法，护士配备水平与降低FBL、PPE、DVT、PSA和PWD之间存在显著关系，长期幅度分别为-2.91、-1.30、-1.69、-2.81和-1.12；基于所有入院方法，相应的长期幅度分别为-6.12、-14.57、-7.29、-1.41和-0.88。
在经合组织国家，护士比例较高与因手术并发症和不良临床结果较低而带来的更高患者安全相关。因此，我们提醒政策制定者注意低估护士对经合组织国家提高患者安全以及医疗服务质量影响的风险。
