与分娩期间护士配备相关的医院特征：最弱势产妇的不平等。
Hospital characteristics associated with nurse staffing during labor and birth: Inequities for the most vulnerable maternity patients.
机构信息
Mercy Hospital Saint Louis, Saint Louis, MO.
Phillip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA.
出版信息
Nurs Outlook. 2023 May-Jun;71(3):101960. doi: 10.1016/j.outlook.2023.101960. Epub 2023 Mar 31.
BACKGROUND
Evidence is limited on nurse staffing in maternity units.
PURPOSE
To estimate the relationship between hospital characteristics and adherence with Association of Women's Health, Obstetric and Neonatal Nurses nurse staffing guidelines.
METHODS
We enrolled 3,471 registered nurses in a cross-sectional survey and obtained hospital characteristics from the 2018 American Hospital Association Annual Survey. We used mixed-effects linear regression models to estimate associations between hospital characteristics and staffing guideline adherence.
FINDINGS
Overall, nurses reported strong adherence to AWHONN staffing guidelines (rated frequently or always met by ≥80% of respondents) in their hospitals. Higher birth volume, having a neonatal intensive care unit, teaching status, and higher percentage of births paid by Medicaid were all associated with lower mean guideline adherence scores.
DISCUSSION AND CONCLUSIONS
Important gaps in staffing were reported more frequently at hospitals serving patients more likely to have medical or obstetric complications, leaving the most vulnerable patients at risk.
背景
有关产科病房护士配置的证据有限。
目的
评估医院特征与遵守妇女健康协会、产科和新生儿护士人员配备指南之间的关系。
方法
我们对 3471 名注册护士进行了横断面调查，并从 2018 年美国医院协会年度调查中获得了医院特征。我们使用混合效应线性回归模型来估计医院特征与人员配备指南遵守之间的关联。
结果
总体而言，护士报告其所在医院对 AWHONN 人员配备指南的高度遵守（≥80%的受访者经常或总是符合标准）。较高的分娩量、拥有新生儿重症监护病房、教学地位以及更多的医疗补助支付的分娩量与较低的平均指南遵守评分相关。
讨论和结论
在为更有可能出现医疗或产科并发症的患者提供服务的医院，人员配备方面存在重要差距，这使最脆弱的患者面临风险。
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