护士结构配置对护理质量结果指标的影响  

The relationship of nurse staffing and nursing-sensitive patient outcomes of quality

作　　者：李振香[1] 王伟[1] 张静[1] 张玉曼[1] 芦凤娟[1] 马梦颖[2] 

机构地区：[1]山东大学附属省立医院护理部,济南市250021 [2]山东大学护理学院

出　　处：《中国护理管理》2016年第7期882-886,共5页Chinese Nursing Management

摘　　要：目的:分析护理结构指标"不同级别护士的配置"对护理结果指标的影响,为中国护理敏感质量指标体系提供基础数据和参考。方法:采取便利抽样法,于2015年在山东省护理质量控制中心的组织下,对山东省121家三级医院(包括10家按三级管理医院)为研究对象进行指标数据采集,以住院患者跌倒发生率、住院患者跌倒伤害率、院内压疮发生率为因变量,以不同级别护士的配置为自变量进行线性回归分析。结果:不同级别护士的配置与3个结果指标之间均存在负相关关系:工作年限≥5年护士占比每增加1%,住院患者跌倒发生率、住院患者跌倒伤害率、院内压疮发生率3个指标分别下降0.130%、0.396%、0.075%;护师及以上护士配置每增加1%,住院患者跌倒伤害率下降0.369%。结论:不同级别护士的配置对护理结果质量有一定的影响,建议各医疗机构可以将不同级别护士的配置作为日常监测指标,用于指导护士人力结构配置,并开展与患者结局和护理质量关联的研究,为管理者提供一种从优化护士人力结构配置角度出发的改善护理质量的参考路径。Objective： To examine the relationships of nurse staffing level with nursing-sensitive patient outcomes. Methods： For this study, data was obtained from 121 tertiary hospitals in Shandong province using convenience sampling. All statistical analyses were done with the R project. The three nursing-sensitive patient outcomes variables included the incidence of falls, injury from a fall after admission, and pressure ulcers. Linear regression was employed to explore the relationships of nurse stafifng level and nursing-sensitive patient outcomes. Results： A larger number of nurse stafifng was signiifcantly associated with a lower incidence of falls, injury from a fall after admission, and pressure ulcers. Conclusions： The ifndings suggest that hospitals could improve nursing quality by improving nurse stafifng. Healthcare strategies and efforts to modify adequate nurse stafifng levels are needed to improve outcomes.

关 键 词：质量指标 结构-过程-结果模式 护理 评价指标 

分 类 号：R47[医药卫生—护理学]