护士与患者配比、护士教育水平和护士敏感型患者结局之间的关联：一项为期12个月的前瞻性观察研究。

Associations between nurse-to-patient ratio, nurse educational level, and nurse-sensitive patient outcomes: A 12-month prospective observational study.

作者信息

Chau Janita Pak Chun, Lo Suzanne Hoi Shan, Choi Kai Chow, Tong Danny Wah Kun, Kwok Angela Mei Ling, Butt Laveeza, Chan Eric Lu Shek, Lee Iris Fung Kam, Lee Diana Tze Fan, Mchugh Matthew D, Thompson David R

机构信息

Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.

Nursing Services Department, Hospital Authority, Hong Kong.

出版信息

Int Nurs Rev. 2025 Mar;72(1):e13091. doi: 10.1111/inr.13091.

DOI:10.1111/inr.13091

PMID:39784291

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11714340/

Abstract

AIM

To investigate the associations between nurse staffing levels, nurse educational level, and nurse-sensitive patient outcomes among patients in medical and surgical wards.

BACKGROUND

Patient outcomes are affected by a variety of factors, including nurse staffing and registered nurse (RN) educational levels. An examination of the associations between these factors and patient outcomes will help identify the impact that nurses make on patient care, including health and safety.

METHODS

A 12-month prospective observational study was conducted in four major hospitals in Hong Kong. Data on nurse staffing were collected daily, while data on nurse-sensitive patient outcomes were retrieved from patient records and nursing documentation. Multiple regression was used to examine the association between each of the outcomes and the explanatory variables including nurse-to-patient ratio and educational qualifications at the ward level. The STROBE guidelines were followed in this study.

RESULTS

The average monthly nurse-to-patient ratio per ward was 1:9.2 (1:7.4 for day (morning and afternoon) and 1:19.1 for night shifts). The percentage of RNs with a bachelor's or higher degree was 83.6%. A higher nurse-to-patient ratio was significantly associated with a larger number of patients with physical restraints and catheter-associated urinary tract infections. A significant association was also found between a higher percentage of RNs with a bachelor's or higher degree and a smaller number of physical restraints used.

CONCLUSIONS

Nurse staffing and educational levels were associated with key patient outcomes such as physical restraint use and incidence of catheter-associated urinary tract infections.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Current nurse staffing strategies should be refined in light of these findings in order to enhance patient health and safety outcomes.

摘要

目的

探讨内科和外科病房患者的护士配备水平、护士教育水平与护士敏感型患者结局之间的关联。

背景

患者结局受多种因素影响，包括护士配备和注册护士（RN）的教育水平。研究这些因素与患者结局之间的关联，将有助于确定护士对患者护理（包括健康和安全）的影响。

方法

在香港的四家主要医院进行了一项为期12个月的前瞻性观察研究。每天收集护士配备数据，同时从患者记录和护理文件中获取护士敏感型患者结局的数据。采用多元回归分析来检验每个结局与解释变量之间的关联，这些解释变量包括病房层面的护患比和教育资质。本研究遵循STROBE指南。

结果

每个病房每月的平均护患比为1:9.2（白天（上午和下午）为1:7.4，夜间为1:19.1）。拥有学士学位或更高学位的注册护士比例为83.6%。较高的护患比与更多使用身体约束的患者以及导尿管相关尿路感染的患者数量显著相关。还发现拥有学士学位或更高学位的注册护士比例较高与使用身体约束的数量较少之间存在显著关联。