Eleanor Turi, Karen B Lasater, Ariel S Kamen, Linda H Aiken, K Jane Muir
{"title":"护理资源对慢性伤口管理的影响：横断面分析。","authors":"Eleanor Turi, Karen B Lasater, Ariel S Kamen, Linda H Aiken, K Jane Muir","doi":"10.1111/jocn.17804","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>Evaluate the relationship between hospital nursing resources and outcomes among patients with chronic wounds.</p><p><strong>Design: </strong>Cross-sectional observational.</p><p><strong>Methods: </strong>Hospital-level predictors included the nurse work environment, proportion of Bachelor of Science (BSN)-prepared nurses, and skill mix (i.e., registered nurses [RN] as proportion of nursing personnel). Outcomes included in-hospital and 30-day mortality, discharging to a higher level of care and length of stay. Individual-level nurse data were aggregated to create hospital-level measures of nursing resources. We utilised multi-level modelling with nurses nested within hospitals and outcomes at the patient level.</p><p><strong>Data: </strong>Three datasets from 2021: RN4CAST-New York/Illinois survey, Medicare Provider Analysis and Review claims and American Hospital Association Annual Survey.</p><p><strong>Results: </strong>The sample included 34,113 patients with chronic wounds in 215 hospitals in New York and Illinois. In adjusted models, a 1 standard deviation improvement in the work environment was associated with 12% lower odds of in-hospital mortality, 8% lower odds of discharging to a higher level of care and a shorter length of stay by a factor of 0.96. A 10% increase in BSN composition was associated with 8% reduced odds of in-hospital mortality and 6% reduced odds of 30-day mortality. A 10% increase in skill mix was associated with 12% lower odds of in-hospital mortality and a shorter length of stay by a factor of 0.91.</p><p><strong>Conclusion: </strong>Improved nursing resources are associated with better outcomes among patients with chronic wounds.</p><p><strong>Implications: </strong>Nurses manage the care of patients with chronic wounds; thus, hospital investment in nursing resources is imperative for good outcomes.</p><p><strong>Impact: </strong>Modifiable hospital nursing resources are associated with outcomes among patients with chronic wounds, a complex population.</p><p><strong>Reporting: </strong>STROBE.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Impact of Nursing Resources on Chronic Wound Management: A Cross-Sectional Analysis.\",\"authors\":\"Eleanor Turi, Karen B Lasater, Ariel S Kamen, Linda H Aiken, K Jane Muir\",\"doi\":\"10.1111/jocn.17804\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>Evaluate the relationship between hospital nursing resources and outcomes among patients with chronic wounds.</p><p><strong>Design: </strong>Cross-sectional observational.</p><p><strong>Methods: </strong>Hospital-level predictors included the nurse work environment, proportion of Bachelor of Science (BSN)-prepared nurses, and skill mix (i.e., registered nurses [RN] as proportion of nursing personnel). Outcomes included in-hospital and 30-day mortality, discharging to a higher level of care and length of stay. Individual-level nurse data were aggregated to create hospital-level measures of nursing resources. We utilised multi-level modelling with nurses nested within hospitals and outcomes at the patient level.</p><p><strong>Data: </strong>Three datasets from 2021: RN4CAST-New York/Illinois survey, Medicare Provider Analysis and Review claims and American Hospital Association Annual Survey.</p><p><strong>Results: </strong>The sample included 34,113 patients with chronic wounds in 215 hospitals in New York and Illinois. In adjusted models, a 1 standard deviation improvement in the work environment was associated with 12% lower odds of in-hospital mortality, 8% lower odds of discharging to a higher level of care and a shorter length of stay by a factor of 0.96. A 10% increase in BSN composition was associated with 8% reduced odds of in-hospital mortality and 6% reduced odds of 30-day mortality. A 10% increase in skill mix was associated with 12% lower odds of in-hospital mortality and a shorter length of stay by a factor of 0.91.</p><p><strong>Conclusion: </strong>Improved nursing resources are associated with better outcomes among patients with chronic wounds.</p><p><strong>Implications: </strong>Nurses manage the care of patients with chronic wounds; thus, hospital investment in nursing resources is imperative for good outcomes.</p><p><strong>Impact: </strong>Modifiable hospital nursing resources are associated with outcomes among patients with chronic wounds, a complex population.</p><p><strong>Reporting: </strong>STROBE.</p>\",\"PeriodicalId\":50236,\"journal\":{\"name\":\"Journal of Clinical Nursing\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-04-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Nursing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/jocn.17804\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/jocn.17804","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
The Impact of Nursing Resources on Chronic Wound Management: A Cross-Sectional Analysis.
Aim: Evaluate the relationship between hospital nursing resources and outcomes among patients with chronic wounds.
Design: Cross-sectional observational.
Methods: Hospital-level predictors included the nurse work environment, proportion of Bachelor of Science (BSN)-prepared nurses, and skill mix (i.e., registered nurses [RN] as proportion of nursing personnel). Outcomes included in-hospital and 30-day mortality, discharging to a higher level of care and length of stay. Individual-level nurse data were aggregated to create hospital-level measures of nursing resources. We utilised multi-level modelling with nurses nested within hospitals and outcomes at the patient level.
Data: Three datasets from 2021: RN4CAST-New York/Illinois survey, Medicare Provider Analysis and Review claims and American Hospital Association Annual Survey.
Results: The sample included 34,113 patients with chronic wounds in 215 hospitals in New York and Illinois. In adjusted models, a 1 standard deviation improvement in the work environment was associated with 12% lower odds of in-hospital mortality, 8% lower odds of discharging to a higher level of care and a shorter length of stay by a factor of 0.96. A 10% increase in BSN composition was associated with 8% reduced odds of in-hospital mortality and 6% reduced odds of 30-day mortality. A 10% increase in skill mix was associated with 12% lower odds of in-hospital mortality and a shorter length of stay by a factor of 0.91.
Conclusion: Improved nursing resources are associated with better outcomes among patients with chronic wounds.
Implications: Nurses manage the care of patients with chronic wounds; thus, hospital investment in nursing resources is imperative for good outcomes.
Impact: Modifiable hospital nursing resources are associated with outcomes among patients with chronic wounds, a complex population.
期刊介绍：
The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice.
JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice.
We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
