Anna Krupp is Assistant Professor, University of Iowa, College of Nursing, 480 CNB, Iowa City, IA 52242 (
Karen B. Lasater is Assistant Professor, Center for Health Outcomes and Policy Research, School of Nursing, and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania.
AACN Adv Crit Care. 2021 Dec 15;32(4):381-390. doi: 10.4037/aacnacc2021383.
Across hospitals, there is wide variation in ICU utilization after surgery. However, it is unknown whether and to what extent the nurse work environment is associated with a patient's odds of admission to an intensive care unit.
To estimate the relationship between hospitals' nurse work environment and a patient's likelihood of ICU admission and mortality following surgery.
A cross-sectional study of 269 764 adult surgical patients in 453 hospitals was conducted. Logistic regression models were used to estimate the effects of the work environment on the odds of patients' admission to the intensive care unit and mortality.
Patients in hospitals with good work environments had 16% lower odds of intensive care unit admission and 15% lower odds of mortality or intensive care unit admission than patients in hospitals with mixed or poor environments.
Patients in hospitals with better nurse work environments were less likely to be admitted to an intensive care unit and less likely to die. Hospitals with better nurse work environments may be better equipped to provide postoperative patient care on lower acuity units.
在不同医院，手术后 ICU 使用率存在很大差异。然而，尚不清楚护士工作环境是否以及在何种程度上与患者入住 ICU 的几率相关。
评估医院护士工作环境与患者术后入住 ICU 和死亡几率之间的关系。
对 453 家医院的 269764 名成年手术患者进行了一项横断面研究。采用 logistic 回归模型评估工作环境对患者入住 ICU 几率和死亡率的影响。
与工作环境混杂或较差的医院相比，工作环境良好的医院的患者 ICU 入住率降低了 16%，死亡率或 ICU 入住率降低了 15%。
护士工作环境较好的医院的患者入住 ICU 的可能性较低，死亡率也较低。护士工作环境较好的医院可能更有能力在较低危的病房为术后患者提供护理。
