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頁籤選單縮合
題名 | Relationships between Nurse Staffing and Patient Outcomes=護理人力配置與病患結果之相關性 |
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作者 | 楊克平; | 書刊名 | The Journal of Nursing Research |
卷期 | 11:3 2003.09[民92.09] |
頁次 | 頁149-158 |
分類號 | 419.83 |
關鍵詞 | 護理人力配置; 病患結果; 病患之負向結果發生率; Nurse staffing; Patient outcomes; Adverse patient outcome occurrences; |
語文 | 英文(English) |
中文摘要 | 許多研究曾顯示護理實務或作業上的改變會影響護理人員與組織結果,然對其顧客,病患結果的影響卻鮮少探究,致未能充份瞭解其間之關係或影響力。本研究之目的在檢視護理人力配置之相關變項,如各護理單位之平均護理時數、護理師與平均病患數之比、工作量與各級護理師之組合比等對病患結果之影響。而病患結果則以跌倒、壓瘡、呼吸道感染、泌尿道感染及病患或家屬之抱怨率等五種負向結果為評量指標。本研究以回溯性 (retrospective) 方式,針對臺灣地區某1394床之醫學中心的21個內外科住院病患2000年之護理品質監測記錄、病患記錄、病患分類系統資料及護理人員配置等資料分析。護理人力配置變項與結果變項間之相關性在控制病患嚴重度(patient acuity)後,以多變項分析(multivariate analysis)處理資料。病患嚴重度與護理時數則以病患分類系統電腦資料庫中擷取。研究結果顯示護理人員的工作量是院內感染的最佳預測指標;而平均護理時數則是五項病患負向結果的最好預測因子。此外,N3佔各級護理師比率較多的單位,其病患之負向結果發生率亦較低。N3或以上層級之護理師人力組合比 (staffing mix) 在維護病患的利益上佔了舉足輕重的角色。本研究結果提供了病患結果 (outcome) 與組織結構 (structure) 有關的實證資料,更突顯了護理人力配置在護理實務品質上的重要性。 |
英文摘要 | Nursing studies have shown that nursing care delivery changes affect staff and organizational outcomes, but the effects on client outcomes have not been studied sufficiently. The purpose of this study was thus to examine the effect of nurse staffing variables- daily average hours of care, ratio of RNs to average patient census, workload, and skill mix- on patient outcomes as measured by five adverse occurrences. The adverse patient occurrences included unit rates of patient falls, pressure ulcers, respiratory and urinary tract infections, and patient/family complaints. Variables were measured retrospectively using consistently available data from each month of fiscal year 2000 from 21 medical-surgical nursing care units in a 1394-bed medical center in Taiwan. Data were analyzed by descriptive and multivariate inferential statistics while controlling for patient acuity level. Results showed that workload of nurses is the most powerful predictor of nosocomial infections and hours of care best predicted the five adverse patient outcome indices. Lower adverse outcome rates were more consistently related to a higher proportion of N3 level of RNs. Patients could fare better when N3s play a significant role in the staffing mix. The findings provide further empirical support for the context of implications that patient outcomes are correlated to organizational structure. It obviously illustrates the relationships between nurse staffing and the quality of nursing practice. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。