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实习护士、增加实习容量与患者安全。一项回顾性队列研究。

Student nurses, increasing placement capacity and patient safety. A retrospective cohort study.

作者信息

Williamson Graham R, Kane Adele, Bunce Jane

机构信息

University of Plymouth School of Nursing and Midwifery. the Exeter School of Nursing, Topsham Rd, Exeter, EX2 6HA, Devon, UK.

University of Plymouth School of Nursing and Midwifery. Drake Circus, Plymouth, PL4 8AA, Devon, UK.

出版信息

Nurse Educ Pract. 2020 Oct;48:102889. doi: 10.1016/j.nepr.2020.102889. Epub 2020 Sep 23.

DOI:10.1016/j.nepr.2020.102889
PMID:32998081
Abstract

One solution to the global nursing shortage is to increase the numbers of student nurses: clinical placements need to increase their capacity to host them. Capacity increases have previously been viewed as problematic if they increase the supervisory burden on registered nurses, and unsafe if they dilute students' supervision. The aim of this study was to assess the impact on specific patient safety measures (pressure ulcers, falls and medications errors) of having students in placement being educated in Collaborative Learning in Practice (which increases capacity) compared to when they were not. Audit data were collected from four NHS trusts in the South West of England in a retrospective cohort study. We received data on 5532 adverse events from 15 clinical areas in four NHS trusts, with 996 students on placement between January 2018 and August 2019. The risk ratio and mean differences for adverse patient events were favourable (RR = 0.9842; 95%CI 0.9604-1.008; mean difference 279, 95%CI 213-346, p = 0.01). There was no statistically significant correlation between increased student numbers and increased adverse patient events. Our data must be interpreted with caution, but we conclude that increasing capacity for student nurses in placements appears to have a positive impact on patient safety.

摘要

应对全球护理人员短缺的一个办法是增加护生数量

临床实习机构需要提高接收护生的能力。以往认为,如果增加护生数量会加重注册护士的监管负担,那么增加接收能力就存在问题;如果会削弱对学生的监管,那么就不安全。本研究的目的是评估与未接受实践协作学习培训(可提高接收能力)的实习护生相比,接受该培训的实习护生对特定患者安全指标(压疮、跌倒和用药错误)的影响。在一项回顾性队列研究中,我们从英格兰西南部的四个国民保健服务信托机构收集了审计数据。我们收到了来自四个国民保健服务信托机构15个临床区域的5532起不良事件的数据,2018年1月至2019年8月期间有996名护生在这些区域实习。患者不良事件的风险比和平均差异是有利的(风险比=0.9842;95%置信区间0.9604-1.008;平均差异279,95%置信区间213-346,p=0.01)。护生数量增加与患者不良事件增加之间没有统计学上的显著相关性。我们的数据必须谨慎解读,但我们得出的结论是,增加实习护生的接收能力似乎对患者安全有积极影响。

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