Associations between nurse-to-patient ratio, nurse educational level, and nurse-sensitive patient outcomes: A 12-month prospective observational study

IF 3.8 3区医学 Q1 NURSING

International Nursing Review Pub Date : 2025-01-09 DOI:10.1111/inr.13091

Janita Pak Chun Chau RN, PhD, FAAN, Suzanne Hoi Shan Lo RN, PhD, Kai Chow Choi BSc, PhD, Danny Wah Kun Tong RN, PhD, Angela Mei Ling Kwok RN, MSc, Laveeza Butt MA, Eric Lu Shek Chan RN, DMgt, FACN, Iris Fung Kam Lee RN, PhD, Diana Tze Fan Lee RN, PhD, FAAN Emeritus, Matthew D. Mchugh RN, PhD, FAAN, David R. Thompson RN, PhD, FAAN

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引用次数: 0

Abstract

Aim

To investigate the associations between nurse staffing levels, nurse educational level, and nurse-sensitive patient outcomes among patients in medical and surgical wards.

Background

Patient outcomes are affected by a variety of factors, including nurse staffing and registered nurse (RN) educational levels. An examination of the associations between these factors and patient outcomes will help identify the impact that nurses make on patient care, including health and safety.

Methods

A 12-month prospective observational study was conducted in four major hospitals in Hong Kong. Data on nurse staffing were collected daily, while data on nurse-sensitive patient outcomes were retrieved from patient records and nursing documentation. Multiple regression was used to examine the association between each of the outcomes and the explanatory variables including nurse-to-patient ratio and educational qualifications at the ward level. The STROBE guidelines were followed in this study.

Results

The average monthly nurse-to-patient ratio per ward was 1:9.2 (1:7.4 for day (morning and afternoon) and 1:19.1 for night shifts). The percentage of RNs with a bachelor's or higher degree was 83.6%. A higher nurse-to-patient ratio was significantly associated with a larger number of patients with physical restraints and catheter-associated urinary tract infections. A significant association was also found between a higher percentage of RNs with a bachelor's or higher degree and a smaller number of physical restraints used.

Conclusions

Nurse staffing and educational levels were associated with key patient outcomes such as physical restraint use and incidence of catheter-associated urinary tract infections.

Implications for nursing and health policy

Current nurse staffing strategies should be refined in light of these findings in order to enhance patient health and safety outcomes.

查看原文本刊更多论文

护士与患者比例、护士教育水平和护士敏感患者结局之间的关系：一项为期12个月的前瞻性观察研究。

目的：探讨内科和外科病房护士配备水平、护士教育水平和护士敏感患者结局之间的关系。背景：患者预后受到多种因素的影响，包括护士配备和注册护士（RN）的教育水平。检查这些因素与患者结果之间的关系将有助于确定护士对患者护理的影响，包括健康和安全。方法：在香港四家大医院进行为期12个月的前瞻性观察研究。每天收集护士人员配置数据，同时从患者记录和护理文件中检索护士敏感患者结果的数据。使用多元回归来检验每个结果与解释变量之间的关系，包括护士与病人的比例和病房水平的教育资格。本研究遵循STROBE指南。结果：月平均每个病房护患比为1:9.2（白班（上午和下午）为1:7.4，夜班为1:19.1）。具有学士及以上学历的注册护士占83.6%。较高的护士与患者比例与更多的身体约束和导尿管相关性尿路感染患者显著相关。研究还发现，拥有学士或更高学位的注册护士比例越高，使用物理约束的次数越少，两者之间也存在显著关联。结论：护士的配备和教育水平与患者的主要结局有关，如身体约束的使用和导尿管相关性尿路感染的发生率。对护理和卫生政策的影响：当前的护士人员配置策略应根据这些发现加以改进，以提高患者的健康和安全结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Nursing Review 医学-护理

CiteScore

7.90

自引率

7.30%

发文量

审稿时长

6-12 weeks

期刊介绍： International Nursing Review is a key resource for nurses world-wide. Articles are encouraged that reflect the ICN"s five key values: flexibility, inclusiveness, partnership, achievement and visionary leadership. Authors are encouraged to identify the relevance of local issues for the global community and to describe their work and to document their experience.