Harrington Charlene, Ross Leslie, Chapman Susan, Halifax Elizabeth, Spurlock Bruce, Bakerjian Debra
Department of Social & Behavioral Sciences, University of California, San Francisco.
Policy Polit Nurs Pract. 2020 Aug;21(3):174-186. doi: 10.1177/1527154420938707. Epub 2020 Jul 7.
In the United States, 1.4 million nursing home residents have been severely impacted by the COVID-19 pandemic with at least 25,923 resident and 449 staff deaths reported from the virus by June 1, 2020. The majority of residents have chronic illnesses and conditions and are vulnerable to infections and many share rooms and have congregate meals. There was evidence of inadequate registered nurse (RN) staffing levels and infection control procedures in many nursing homes prior to the outbreak of the virus. The aim of this study was to examine the relationship of nurse staffing in California nursing homes and compare homes with and without COVID-19 residents. Study data were from both the California and Los Angeles Departments of Public Health and as well as news organizations on nursing homes reporting COVID-19 infections between March and May 4, 2020. Results indicate that nursing homes with total RN staffing levels under the recommended minimum standard (0.75 hours per resident day) had a two times greater probability of having COVID-19 resident infections. Nursing homes with lower Medicare five-star ratings on total nurse and RN staffing levels (adjusted for acuity), higher total health deficiencies, and more beds had a higher probability of having COVID-19 residents. Nursing homes with low RN and total staffing levels appear to leave residents vulnerable to COVID-19 infections. Establishing minimum staffing standards at the federal and state levels could prevent this in the future.
在美国，140万养老院居民受到新冠疫情的严重影响，截至2020年6月1日，该病毒已导致至少25923名居民和449名工作人员死亡。大多数居民患有慢性疾病，容易感染，许多人共享房间并集体用餐。在病毒爆发之前，有证据表明许多养老院的注册护士（RN）人员配备水平和感染控制程序不足。本研究的目的是研究加利福尼亚州养老院护士人员配备的关系，并比较有无新冠患者的养老院。研究数据来自加利福尼亚州和洛杉矶公共卫生部以及新闻机构关于2020年3月至5月4日报告新冠感染情况的养老院。结果表明，注册护士总人员配备水平低于建议最低标准（每位居民每天0.75小时）的养老院，其新冠患者感染的可能性高出两倍。在护士和注册护士总人员配备水平（根据病情严重程度调整）、总体健康缺陷较多以及床位较多的情况下，医疗保险五星级评级较低的养老院，出现新冠患者的可能性更高。注册护士和总人员配备水平较低的养老院似乎使居民容易受到新冠感染。在联邦和州层面制定最低人员配备标准，未来可以防止这种情况发生。
