Neves Teresa Margarida Almeida, Parreira Pedro Miguel Santos Dinis, Rodrigues Victor José Lopes, Graveto João Manuel Garcia Nascimento
Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Escola Superior de Enfermagem de Coimbra, Coimbra, Portugal.
J Nurs Manag. 2021 Jul;29(5):1246-1255. doi: 10.1111/jonm.13263. Epub 2021 Feb 11.
To assess the impact of safe nurse staffing on the quality of care, based on the structure-process-outcome approach, in Portuguese hospitals.
Safe nurse staffing is essential for the quality of care in hospital settings, together with work environment, organisational commitment and nursing practices. However, there is little evidence of its analysis in the Portuguese context.
A cross-sectional survey study was conducted using a sample of 850 nurses from 12 public hospital units in the central and northern regions of Portugal.
The proposed structural equation model for quality assessment has a good fit (χ /df = 2.37; CFI = 0.88, PCFI = 0.83; PGFI = 0.77, RMSEA = 0.04), showing the impact of safe nurse staffing, work environment, and affective and normative organisational commitment on the quality of care (mortality rate and adverse events). The mediating effect of nursing practices was also found.
Safe nurse staffing, which is compromised in 90% of the units, is a predictor of the quality of care through the mediating effect of nursing practices.
The results not only highlight the need for urgent intervention but also support political decision-making with a view to improving the access to quality care.
基于结构-过程-结果方法，评估葡萄牙医院安全护士配置对护理质量的影响。
安全护士配置与工作环境、组织承诺和护理实践一样，对医院环境中的护理质量至关重要。然而，在葡萄牙背景下，对其进行分析的证据很少。
采用横断面调查研究，对来自葡萄牙中部和北部地区12个公立医院科室的850名护士进行抽样。
所提出的质量评估结构方程模型拟合良好（χ²/df = 2.37；CFI = 0.88，PCFI = 0.83；PGFI = 0.77，RMSEA = 0.04），显示了安全护士配置、工作环境以及情感和规范组织承诺对护理质量（死亡率和不良事件）的影响。还发现了护理实践的中介作用。
90%的科室安全护士配置不足，安全护士配置通过护理实践的中介作用成为护理质量的一个预测因素。
研究结果不仅突出了紧急干预的必要性，还为旨在改善优质护理可及性的政策决策提供了支持。
