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根据护士人员配备水平评估接受经皮冠状动脉介入治疗患者的住院死亡率:国家行政健康数据分析。

In-Hospital Mortality in Patients Receiving Percutaneous Coronary Intervention According to Nurse Staffing Level: An Analysis of National Administrative Health Data.

机构信息

School of Nursing, Eulji University, 553 Sanseong-Daero, Sujeong-Gu, Seongnam-Si, Gyeonggi-Do 13135, Korea.

School of Nursing, Gachon University, 191 Hambakmoero, Yeonsu-gu, Incheon 21936, Korea.

出版信息

Int J Environ Res Public Health. 2020 May 27;17(11):3799. doi: 10.3390/ijerph17113799.

Abstract

The increasing incidence of ischemic heart disease is concomitantly increasing percutaneous coronary intervention (PCI) treatments. Adequate nurse staffing has enhanced quality of care and this study was conducted to determine the relationship between survival-related PCI treatment and the level of nursing staff who care for patients admitted to receive PCI. National Health Insurance claims data from 2014 to 2015 for 67,927 patients who underwent PCI in 43 tertiary hospitals were analyzed. The relationships of nurse staffing in intensive care units (ICUs) and general wards with survival after PCI were investigated using logistic regression analyses with a generalized estimation model. The in-hospital mortality rate in ICUs was lower in hospitals with first-grade nurse staffing {odds ratio (OR) = 0.33, 95% confidence interval (CI) = 0.23-0.48}, second-grade nurse staffing (OR = 0.55, 95% CI = 0.40-0.77), or third-grade nurse staffing (OR = 0.71, 95% CI = 0.53-0.95) than in hospitals with fifth-grade nurse staffing. Nurse staffing in general wards was not related to in-hospital mortality due to PCI treatment. This study found that nurse staffing in PCI patients requiring short-term intensive care significantly affected patient survival. An understanding of the importance of managing the ICU nursing workforce for PCI treatment is required.

摘要

缺血性心脏病的发病率不断上升,同时经皮冠状动脉介入治疗(PCI)的数量也在增加。充足的护士配备提高了护理质量,本研究旨在确定与生存相关的 PCI 治疗与护理接受 PCI 治疗患者的护士人数之间的关系。分析了 2014 年至 2015 年全国健康保险索赔数据中 43 家三级医院 67927 例接受 PCI 的患者。使用广义估计模型的逻辑回归分析调查了 ICU 和普通病房护士配备与 PCI 后生存的关系。具有一级护士配备(OR=0.33,95%置信区间[CI]:0.23-0.48),二级护士配备(OR=0.55,95%CI:0.40-0.77)或三级护士配备(OR=0.71,95%CI:0.53-0.95)的医院的 ICU 住院死亡率低于具有五级护士配备的医院。普通病房护士配备与 PCI 治疗的住院死亡率无关。本研究发现,需要短期重症监护的 PCI 患者的护士配备显著影响患者的生存。需要了解管理 PCI 治疗 ICU 护理人员的重要性。

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