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中国护理工作时长与护理质量、护理缺失及护理执业环境的关系:一项多中心横断面研究

Working Hours Associated with the Quality of Nursing Care, Missed Nursing Care, and Nursing Practice Environment in China: A Multicenter Cross-Sectional Study.

作者信息

Li Miqi, Wang Ying, Du Meichen, Wang Hui, Liu Yanqun, Richardson Brianna N, Bai Jinbing

机构信息

Tongji Hospital, Tongji Medical College, Huazhong University of Science and Tecnology, Wuhan, Hubei, China.

Center for Women and Children Health and Metabolism Research, Wuhan University School of Nursing, Wuhan University, Wuhan, Hubei, China.

出版信息

J Nurs Manag. 2023 Nov 6;2023:8863759. doi: 10.1155/2023/8863759. eCollection 2023.


DOI:10.1155/2023/8863759
PMID:40225634
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11918823/
Abstract

AIM: The aim of the study was to examine the effect of the length of working hours on missed nursing care, quality of nursing care, and perceptions of the nursing practice environment. METHODS: A multicenter cross-sectional investigation using online questionnaires was conducted from April 2 to May 10, 2022, in twenty nine hospitals (13 Level-III hospitals and 16 Level-II hospitals). We collected data on the working hours of nurses and nurse-reported outcomes, including missed nursing care, quality of nursing care, and nursing practice environment. Restricted cubic spline (RCS) regression models were used to examine relationships between the hours per shift and nurse-reported outcomes. RESULTS: We investigated 12,703 nurses with a response rate of 97.33%. Nurses worked on average 7.72 (SD = 1.16) hours on the day shift and 8.92 (SD = 2.20) hours on the night shift, respectively. On the day shift, working 7.5 hours shift showed minimal missed nursing care; meanwhile, working 7-7.5 hours were correlated with the highest satisfaction of the nursing practice environment and better quality of nursing care. On the night shift, the highest missed nursing care was found for a working duration of 12 hours to the working 7 hours, with the lowest satisfaction while better quality was observed. The percentage of nurses who reported working overtime was 30.33%. Nurses who worked overtime reported lower satisfaction and poorer quality of nursing care on all shifts; moreover, working overtime showed the positive correlation to missed nursing care on the day shift, while on night shift was not statistically significant. CONCLUSION: Positive outcomes were observed for nurses who reported working 7-7.75 hours on the day shift and 12 hours (no more than 15 hours) on the night shift. . The results reemphasized the need for managers to reduce the working hours, overtime work, and the frequency of the night shift.

摘要

目的:本研究旨在探讨工作时长对护理缺失、护理质量以及护理实践环境认知的影响。 方法:2022年4月2日至5月10日,在29家医院(13家三级医院和16家二级医院)采用在线问卷进行了多中心横断面调查。我们收集了护士的工作时长以及护士报告的结果数据,包括护理缺失、护理质量和护理实践环境。使用受限立方样条(RCS)回归模型来检验每班工作时长与护士报告结果之间的关系。 结果:我们调查了12703名护士,回复率为97.33%。护士日班平均工作7.72(标准差=1.16)小时,夜班平均工作8.92(标准差=2.20)小时。在日班,工作7.5小时时护理缺失最少;同时,工作7至7.5小时与护理实践环境的最高满意度以及更好的护理质量相关。在夜班,工作时长为12小时至7小时时护理缺失最多,满意度最低,不过护理质量较好。报告加班的护士比例为30.33%。加班的护士在所有班次上报告的满意度较低,护理质量较差;此外,日班加班与护理缺失呈正相关,而夜班则无统计学意义。 结论:日班工作7至7.75小时、夜班工作12小时(不超过15小时)的护士有积极结果。研究结果再次强调管理人员需要减少工作时长、加班以及夜班频率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6093/11918823/ac02b9e31e48/JONM2023-8863759.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6093/11918823/ff677186cf87/JONM2023-8863759.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6093/11918823/7952bd56372f/JONM2023-8863759.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6093/11918823/9ebbf64c40aa/JONM2023-8863759.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6093/11918823/ac02b9e31e48/JONM2023-8863759.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6093/11918823/ff677186cf87/JONM2023-8863759.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6093/11918823/7952bd56372f/JONM2023-8863759.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6093/11918823/9ebbf64c40aa/JONM2023-8863759.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6093/11918823/ac02b9e31e48/JONM2023-8863759.004.jpg

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Working Hours Associated with the Quality of Nursing Care, Missed Nursing Care, and Nursing Practice Environment in China: A Multicenter Cross-Sectional Study.

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本文引用的文献

[1]
Predictors of nurses' attitudes and knowledge towards pain management in Italy. A cross-sectional study in the hospital settings.

Appl Nurs Res. 2021-12

[2]
Work hours and overtime of nurses working in Cambodian hospitals.

Int Nurs Rev. 2022-6

[3]
The effects of three consecutive 12-hour shifts on cognition, sleepiness, and domains of nursing performance in day and night shift nurses: A quasi-experimental study.

Int J Nurs Stud. 2021-11

[4]
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PLoS One. 2021

[5]
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JAMA Netw Open. 2021-2-1

[6]
Perception of nurses on the practice environment: experience from Malaysia.

Med J Malaysia. 2021-1

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PLoS One. 2020-10-28

[8]
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Kaohsiung J Med Sci. 2021-2

[9]
The Effect of Nurse Practice Environment on Retention and Quality of Care via Burnout, Work Characteristics, and Resilience: A Moderated Mediation Model.

J Nurs Adm. 2020-10

[10]
Sleep diary- and actigraphy-derived sleep parameters of 8-hour fast-rotating shift work nurses: A prospective descriptive study.

Int J Nurs Stud. 2020-12

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