Hermes C, Petersen-Ewert C
, Friedrich-Ebert-Straße 60, 53177, Bonn, Deutschland.
Fakultät Wirtschaft & Soziales - Department Pflege & Management, Hochschule für Angewandte Wissenschaften Hamburg (HAW Hamburg), Hamburg, Deutschland.
Med Klin Intensivmed Notfmed. 2022 Feb;117(1):16-23. doi: 10.1007/s00063-020-00753-5. Epub 2020 Oct 21.
Temporary contract workers are used for the nursing care of intensive care patients, usually by service providers in the sense of temporary employment. If or how temporary contract work has an impact on patient care has scarcely been investigated so far.
The aim of this systematic review is to describe the available research results on the use of temporary workers in nursing care in intensive and intermediate care units and to summarize the prospective effects on patient outcomes.
Seven databases were systematically searched for English and German language articles using Boolean operators and evaluated according to the PRISMA schema. References of included studies were included in the search and the quality of all included studies was evaluated according to the Hawker criteria.
From a total of 630 datasets viewed, 1 qualitative and 2 quantitative studies were identified and analyzed. The findings of the quantitative studies indicated that the probability of the occurrence of catheter-associated infections can increase with the use of temporary workers, but is more dependent on the size of the unit: For each additional bed, the probability of VAP increases by 14.8% (95%-CI = 1.032-1.277, p = 0.011). However, trends for a decrease in the sepsis rate as soon as fewer temporary workers (hours/patient) were deployed in the intensive care unit (ICU) could not be confirmed.
In the few available studies no evidence was found that the use of temporary workers in intensive care units (ICU) and intermediate care units (IMC) has a significant impact on patient outcomes; however, evidence was found that individual qualifications and working conditions have an influence on outcomes. Further studies should consider what ratio of permanent to temporary workers should be considered uncritical, what qualifications temporary workers should have and to what extent these can be checked.
临时合同工通常由劳务中介机构派遣，负责重症监护患者的护理工作。目前，临时合同工对患者护理的影响尚未得到充分研究。
本系统综述旨在总结现有关于临时合同工在重症监护病房和中级护理病房护理工作中的研究成果，并概括其对患者预后的潜在影响。
通过布尔运算符在7个数据库中系统检索英文和德文文献，并按照PRISMA流程进行评估。纳入研究的参考文献也纳入检索范围，并根据霍克标准评估所有纳入研究的质量。
在总共630个数据集中，确定并分析了1项定性研究和2项定量研究。定量研究结果表明，使用临时合同工可能会增加导管相关感染的发生率，但这更多地取决于病房规模：每增加一张床位，呼吸机相关性肺炎的发生率增加14.8%（95%置信区间=1.032-1.277，p=0.011）。然而，在重症监护病房减少临时合同工的工作时长（小时/患者）是否能降低败血症发生率的趋势尚未得到证实。
在现有少数研究中，未发现临时合同工在重症监护病房和中级护理病房的使用对患者预后有显著影响；但有证据表明，个人资质和工作条件会对预后产生影响。未来研究应考虑何种比例的长期工与临时工组合被认为是合理的，临时工应具备何种资质，以及这些资质可以在多大程度上得到核实。
