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重症监护病房护理不足的现状及影响因素:一项聚焦人员短缺、工作量和护理疏漏的横断面研究

Current Status and Influencing Factors of Nursing Care Insufficiency in Intensive Care Units: A Cross-Sectional Study Focusing on Staff Shortages, Workload, and Care Omissions.

作者信息

Yang Yan, Zhou Lihua, Zhang Lin, Wang Miao, Hu Shaohua

机构信息

School of Nursing, Anhui Medical University, Hefei, Anhui Province, People's Republic of China.

Department of Nursing, Anqing Municipal Hospital, Anqing, Anhui Province, People's Republic of China.

出版信息

Risk Manag Healthc Policy. 2025 Apr 24;18:1407-1417. doi: 10.2147/RMHP.S494860. eCollection 2025.

DOI:10.2147/RMHP.S494860
PMID:40297830
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12036680/
Abstract

OBJECTIVE

This study aims to investigate the status of nursing care omissions in intensive care units (ICUs) in China and identify factors influencing these omissions.

METHODS

A cross-sectional study was conducted with 1162 ICU nurses from 30 hospitals across nine provinces in China. Data were collected using questionnaires on nursing care omissions, clinical leadership (nurses' ability to influence and coordinate care), and safety attitudes (perceptions of safety culture). Descriptive statistics, correlation analysis, and multiple linear regression were performed using SPSS.

RESULTS

The mean score for nursing care omissions is 57.38±21.27, clinical leadership is 59.13±15.30, and safety attitudes is 119.00±21.16. A negative correlation is observed between ICU nursing care omission scores and clinical leadership scores (r=-.212, p<0.001), and a negative correlation is observed between ICU nursing care omission scores and safety attitude scores (r=-.241, p<0.001). The multiple linear regression analysis indicates that the factors influencing nursing care omissions in the ICU includes nurses' age, position, personnel relationships, average monthly income, satisfaction with the ward teamwork, frequency of patient safety education, and clinical leadership and safety attitudes (p<0.05).

CONCLUSION

This study found that nursing deficiency in ICU is significant, affecting patient safety, nurse burnout, and nursing quality. Key factors include nurse age, position, and so on. It is recommended to strengthen clinical leadership training, improve safety culture, and optimize staffing to reduce nursing omissions and improve patient outcomes. It calls on health policies to pay attention to ICU nursing deficiencies and formulate support measures to ensure patient safety and nurse health.

摘要

目的

本研究旨在调查中国重症监护病房(ICU)护理缺失的现状,并确定影响这些缺失的因素。

方法

对来自中国九个省份30家医院的1162名ICU护士进行了横断面研究。使用关于护理缺失、临床领导力(护士影响和协调护理的能力)和安全态度(对安全文化的认知)的问卷收集数据。使用SPSS进行描述性统计、相关性分析和多元线性回归。

结果

护理缺失的平均得分为57.38±21.27,临床领导力为59.13±15.30,安全态度为119.00±21.16。观察到ICU护理缺失得分与临床领导力得分之间存在负相关(r = -0.212,p < 0.001),并且ICU护理缺失得分与安全态度得分之间存在负相关(r = -0.241,p < 0.001)。多元线性回归分析表明,影响ICU护理缺失的因素包括护士年龄、职位、人际关系、月平均收入、对病房团队合作的满意度、患者安全教育频率以及临床领导力和安全态度(p < 0.05)。

结论

本研究发现ICU护理缺陷严重,影响患者安全、护士倦怠和护理质量。关键因素包括护士年龄、职位等。建议加强临床领导力培训,改善安全文化,优化人员配置,以减少护理缺失并改善患者结局。呼吁卫生政策关注ICU护理缺陷并制定支持措施,以确保患者安全和护士健康。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec46/12036680/0489488c261d/RMHP-18-1407-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec46/12036680/6740a68f5d64/RMHP-18-1407-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec46/12036680/0489488c261d/RMHP-18-1407-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec46/12036680/6740a68f5d64/RMHP-18-1407-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec46/12036680/0489488c261d/RMHP-18-1407-g0002.jpg

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本文引用的文献

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Intensive Crit Care Nurs. 2023 Oct;78:103480. doi: 10.1016/j.iccn.2023.103480. Epub 2023 Jun 26.
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Teamwork, clinical leadership skills and environmental factors that influence missed nursing care - A qualitative study on hospital wards.团队合作、临床领导技能以及影响护理缺失的环境因素——一项关于医院病房的定性研究
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Missed Nursing Care in the Postanesthesia Care Unit: A Cross-Sectional Study.术后恢复室护理缺失:一项横断面研究。
J Perianesth Nurs. 2021 Jun;36(3):232-237. doi: 10.1016/j.jopan.2020.10.009. Epub 2021 Feb 19.
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