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新冠疫情期间错失的护理:一项比较观察性研究。

Missed nursing care during the COVID-19 pandemic: A comparative observational study.

机构信息

Heart, Vascular and Neuro Theme, Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.

Karolinska Institutet Department of Clinical Neuroscience, Stockholm, Sweden.

出版信息

J Nurs Manag. 2021 Nov;29(8):2343-2352. doi: 10.1111/jonm.13392. Epub 2021 Jul 4.

Abstract

AIM

To evaluate frequencies, types of and reasons for missed nursing care during the COVID-19 pandemic at inpatient wards in a highly specialized university hospital.

BACKGROUND

Registered nurse/patient ratio and nursing competence are known to affect patient outcomes. The first wave of the COVID-19 pandemic entailed novel ways for staffing to meet the expected increased acute care demand, which potentially could impact on quality of care.

METHODS

A comparative cross-sectional study was conducted, using the MISSCARE Survey. A sample of nursing staff during the first wave of the COVID-19 pandemic (n = 130) was compared with a reference sample (n = 157).

RESULTS

Few differences between samples concerning elements of missed care and no significant differences concerning reasons for missed care were found. Most participants perceived the quality of care and the patient safety to be good.

CONCLUSION

The results may be explained by three factors: maintained registered nurse/patient ratio, patients' dependency levels and that nursing managers could maintain the staffing needs with a sufficient skill mix.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing managers impact on the occurrence of MNC; to provide a sufficient registered nurse/patient ratio and skill mix when staffing. They play an important role in anticipatory planning and during infectious disease outbreaks.

摘要

目的

评估 COVID-19 大流行期间某高度专业化大学附属医院住院病房护理缺如的频率、类型和原因。

背景

注册护士与患者的比例和护理能力已知会影响患者结局。COVID-19 大流行的第一波疫情带来了新的人员配备方式,以满足预期的急性护理需求增加,这可能会对护理质量产生影响。

方法

采用 MISSCARE 调查进行了一项比较性的横断面研究。对 COVID-19 大流行第一波疫情期间的护理人员样本(n=130)与参考样本(n=157)进行了比较。

结果

在护理缺如的要素方面,两个样本之间几乎没有差异,在护理缺如的原因方面,也没有显著差异。大多数参与者认为护理质量和患者安全状况良好。

结论

这些结果可以用三个因素来解释:维持注册护士与患者的比例、患者的依赖程度以及护理管理人员可以通过足够的技能组合来维持人员配备需求。

护理管理的意义

护理管理人员影响着重大护理差错的发生;在人员配备时,要提供足够的注册护士与患者的比例和技能组合。他们在预测性规划和传染病爆发期间发挥着重要作用。

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