减少英语水平有限的个体在急诊科治疗结果方面的差异：护士的工作环境。
Reducing disparities in emergency department outcomes for individuals with limited English proficiency: The nurse work environment.
作者信息
Muir Kathryn Jane, Sliwinski Kathy, Lasater Karen B
机构信息
Center for Health Outcomes and Policy Research T32, University of Pennsylvania School of Nursing, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA; Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA.
Center for Health Services & Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, IL.
出版信息
Nurs Outlook. 2025 Jan-Feb;73(1):102318. doi: 10.1016/j.outlook.2024.102318. Epub 2024 Nov 28.
BACKGROUND
Patients with limited English proficiency (LEP) experience worse emergency department (ED) outcomes.
PURPOSE
To evaluate the association between nurses' work environments and ED outcomes among individuals with and without LEP.
METHODS
Cross-sectional study of 1,358,802 patients seen in 64 New Jersey hospital EDs. Nurse work environment was measured by the Practice Environment Scale of the Nursing Work Index. Outcomes included 72-hr ED revisits, and departures against medical advice (AMA).
DISCUSSION
Individuals with LEP experienced higher odds of a 72-hr ED revisit (aOR 1.12, 95% CI 1.04-1.21, p < .001) and lower odds of AMA departure (aOR 0.67, 95% CI, 0.61-0.74, p < .001). An interaction was found between LEP status and the nurse work environment: individuals with LEP experienced lower odds of a 72-hr ED revisit in better vs. poor nurse work environments, compared those without LEP.
CONCLUSION
Disparities in LEP outcomes might be ameliorated by targeted improvements to nurses' work environments.
背景
英语水平有限（LEP）的患者在急诊科（ED）的治疗结果较差。
目的
评估护士工作环境与有无LEP个体的急诊科治疗结果之间的关联。
方法
对新泽西州64家医院急诊科的1358802名患者进行横断面研究。护士工作环境通过护理工作指数实践环境量表进行测量。结果包括72小时内急诊科复诊以及违反医嘱自行出院（AMA）。
讨论
LEP个体72小时内急诊科复诊的几率更高（调整后比值比[aOR]为1.12，95%置信区间[CI]为1.04 - 1.21，p <.001），AMA出院的几率更低（aOR为0.67，95% CI为0.61 - 0.74，p <.001）。发现LEP状态与护士工作环境之间存在交互作用：与无LEP个体相比，LEP个体在护士工作环境较好与较差的情况下，72小时内急诊科复诊的几率更低。
结论
针对护士工作环境进行有针对性的改善可能会减轻LEP患者治疗结果的差异。
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