Blegen M A, Vaughn T
College of Nursing, University of Iowa, Iowa City, USA.
Nurs Econ. 1998 Jul-Aug;16(4):196-203.
Restructuring of nursing care models has led to more "non-professional" caregivers, sometimes called unlicensed assistive personnel (UAPs) who provide more of the basic delegable direct patient care activities in collaboration with RNs. The purpose of this study, wherein data were collected from 39 units in 11 hospitals, was to determine the relationship between different levels of nurse staffing and patient outcomes (adverse occurrences). Using and tracking the same indicators of patient quality outcomes over a significant time period in different institutions with similar patient groups would greatly enhance the usefulness of such data. Among the more surprising findings in this study was the "non-linear" relationship between the proportion of RNs in the staff mix and MAEs. As the proportion of RNs on a unit increased from 50% to 85% "the rate of MAEs declined, but as the RN proportion increased from 85% to 100% the rate of MAEs increased." Further investigations are needed to explain this finding.
护理模式的重组导致出现了更多“非专业”护理人员，有时被称为无执照辅助人员（UAPs），他们与注册护士（RNs）协作，承担了更多可委托的直接患者护理基础工作。本研究从11家医院的39个科室收集数据，目的是确定不同水平的护士配备与患者结局（不良事件）之间的关系。在不同机构中，针对相似患者群体，在一段较长时间内使用并跟踪相同的患者质量结局指标，将极大提高此类数据的有用性。该研究中较令人惊讶的发现之一是，员工组合中注册护士的比例与医疗不良事件（MAEs）之间存在“非线性”关系。当科室中注册护士的比例从50%增加到85%时，“医疗不良事件发生率下降，但当注册护士比例从85%增加到100%时，医疗不良事件发生率上升。”需要进一步调查来解释这一发现。
