Palese Alvisa, Ambrosi Elisa, Guarnier Annamaria, Barelli Paolo, Zambiasi Paola, Allegrini Elisabetta, Bazoli Letizia, Casson Paola, Marin Meri, Padovan Marisa, Picogna Michele, Taddia Patrizia, Salmaso Daniele, Chiari Paolo, Frison Tiziana, Marognolli Oliva, Canzan Federica, Grassetti Luca, Saiani Luisa
Assist Inferm Ric. 2020 Jan-Mar;39(1):35-46. doi: 10.1702/3371.33475.
. Factors associated to patients' outcomes in medical units: lessons learnt from an Italian multicentric longitudinal study design (ESAMED study).
Research on nursing outcomes attempted to identify the associated factors, however, with mainly retrospective or descriptive studies. In 2011, an Italian network was established and a multicentric longitudinal study aimed at exploring factors associated with nursing outcomes among in-hospital medical patients was started.
To summarise (a) how the research project was originated, (b) which patients have been involved, variables and instruments used, (c) the main findings, and (d) the lessons learnt.
12 acute medical units from 11 Italian hospitals were involved. A consecutive sample was adopted: on a daily basis, data has been collected at the (a) patient; (b) nursing care, and (c) hospital levels.
The effect of the variability in the amount of nursing care and skill mix in medical units was explored on the following outcomes: (a) hospital-acquired functional dependence, (b) prevalence and incidence of (i) episodes of hyperactive delirium, (ii) avoidable pressure ulcers; (iii) peripheral venous catheter phlebitis; (c) dissatisfaction with the nursing care; and (d) in-hospital mortality; 1464 out of 2082 eligible patients were involved. The frequency and reasons of Missed Nursing Care (MNC), as well as the presence of family caregivers at the bedside were also measured.
The study confirmed that (a) the amount of nursing care provided by graduate nurses improves patient outcomes; (b) a skill mix in favour of nursing aides, negatively impacts on patients' outcomes; and (c) a higher frequency of MNC threatens patient outcomes.
医疗科室中与患者结局相关的因素：来自一项意大利多中心纵向研究设计（ESAMED研究）的经验教训
关于护理结局的研究试图确定相关因素，但主要是回顾性或描述性研究。2011年，一个意大利网络成立，并启动了一项多中心纵向研究，旨在探索住院内科患者护理结局的相关因素。
总结（a）该研究项目的起源方式，（b）涉及的患者、使用的变量和工具，（c）主要研究结果，以及（d）经验教训。
涉及来自11家意大利医院的12个急性内科科室。采用连续抽样：每天在（a）患者、（b）护理和（c）医院层面收集数据。
探讨了内科科室护理量和技能组合的变异性对以下结局的影响：（a）医院获得性功能依赖，（b）（i）躁动谵妄发作、（ii）可避免的压疮、（iii）外周静脉导管静脉炎的患病率和发病率；（c）对护理的不满；以及（d）住院死亡率；2082名符合条件的患者中有1464名参与。还测量了漏护（MNC）的频率和原因，以及床边是否有家庭照顾者。
该研究证实（a）本科护士提供的护理量可改善患者结局；（b）有利于护理辅助人员的技能组合对患者结局有负面影响；（c）较高频率的漏护会威胁患者结局。
