护士人员配备覆盖情况和护理复杂性因素对COVID-19住院患者健康结局的影响：一项横断面研究。
Impact of nurse staffing coverage and care complexity factors on health outcomes in hospitalized COVID-19 patients: a cross-sectional study.
作者信息
Adamuz Jordi, González-Samartino Maribel, Jiménez-Martínez Emilio, Tapia-Pérez Marta, López-Jiménez María-Magdalena, Valero-Valdelvira Patricia, Zuriguel-Pérez Esperanza, Berbis-Morelló Carmen, Asensio-Flores Susana, Juvé-Udina Maria-Eulàlia
机构信息
Nursing Knowledge Management and Information Systems Department, Hospital Universitari de Bellvitge - IDIBELL, Feixa Llarga s/n, L'Hospitalet de Llobregat (Barcelona), 08907, Spain.
Faculty of Nursing, University of Barcelona, L'Hospitalet de Llobregat, Spain.
出版信息
BMC Nurs. 2025 May 13;24(1):520. doi: 10.1186/s12912-025-03142-5.
BACKGROUND
Few studies have captured the impact of inadequate nurse staffing levels and broader health patient conditions in admitted patients during the COVID-19 pandemic. We aimed to determine the association between nurse staffing coverage, care complexity individual factors (CCIFs) and adverse events (AEs) in patients admitted with COVID-19.
METHODS
A multicentre cross-sectional study was conducted from March 1, 2020 to March 31, 2022 at eight public health hospitals in Spain. All patients with COVID-19 who were admitted to these hospitals were included. The main variables included AEs, nurse staffing coverage (as measured using the ATIC patient classification system) and CCIFs to evaluate broader patient health conditions. Adjusted logistic models were performed to identify associations with AEs, stratified by patients admitted to wards and hospitalized patients who required admission to intensive care units (ICUs).
RESULTS
A total of 11,968 hospitalized patients, 2,824 (23.6%) experienced AEs. Multivariate analysis showed that higher levels of nurse staffing coverage protected against AEs. Among patients admitted to acute wards, the independent risk factors for AEs included old age, haemodynamic instability, chronic disease, uncontrolled pain, urinary or faecal incontinence and mental status impairments. In addition to these factors, extreme weight, position impairment and communication disorders were factors associated with AEs in patients who required ICU admission.
CONCLUSIONS
Nurse staffing coverage was a protective factor for AEs. Several CCIFs related to comorbidity/complications, developmental, and mental-cognitive domains were strongly associated with AEs. Therefore, ensuring safe nurse staffing levels could be improve patient outcomes.
背景
在新冠疫情期间，很少有研究关注到护士人员配备不足以及更广泛的患者健康状况对住院患者的影响。我们旨在确定新冠确诊住院患者中护士人员配备覆盖率、护理复杂性个体因素（CCIFs）与不良事件（AEs）之间的关联。
方法
2020年3月1日至2022年3月31日，在西班牙的八家公立医院进行了一项多中心横断面研究。纳入所有入住这些医院的新冠患者。主要变量包括不良事件、护士人员配备覆盖率（使用ATIC患者分类系统衡量）和CCIFs，以评估更广泛的患者健康状况。采用校正逻辑模型来确定与不良事件的关联，并按病房住院患者和需要入住重症监护病房（ICU）的住院患者进行分层。
结果
共有11968例住院患者，其中2824例（23.6%）发生了不良事件。多变量分析表明，较高水平的护士人员配备覆盖率可预防不良事件。在急性病房住院的患者中，不良事件的独立危险因素包括老年、血流动力学不稳定、慢性病、疼痛控制不佳、尿失禁或大便失禁以及精神状态受损。除这些因素外，极端体重、体位受损和沟通障碍是需要入住ICU的患者发生不良事件的相关因素。
结论
护士人员配备覆盖率是不良事件的一个保护因素。一些与合并症/并发症、发育和心理认知领域相关的CCIFs与不良事件密切相关。因此，确保安全的护士人员配备水平可以改善患者预后。
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