护士结构配置对护理质量结果指标的影响-中国护理管理.PDF

特别策划·质量指标管理 Special Planning 护士结构配置对护理质量结果指标的影响 李振香 王伟 张静 张玉曼 芦凤娟 马梦颖 [ 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。 [ 关键词 ] 质量指标；结构-过程 -结果模式；护理；评价指标 [中图分类号] R47 [DOI] 10.3969/j.issn.1672-1756.2016.07.005 The relationship of nurse staffing and nursing-sensitive patient outcomes of quality / LI Zhenxiang, WANG Wei, ZHANG Jing, ZHANG Yuman, LU Fengjuan, MA Mengying // Nursing department, Shandong provincial hospital affiliated to Shandong university, Jinan, 250021 China /// Chinese Nursing Management-2016,16(7): 882-886 [Abstract] 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 staffing level and nursing-sensitive patient outcomes. Results: A larger number of nurse staffing was significantly associated with a lower incidence of falls, injury from a fall after admission, and pressure ulcers. Conclusions: The findings suggest that hospitals could improve nursing quality by improving nurse staffing. Healthcare st