患者预后和医院护士工作量:斯洛文尼亚医院使用RN4CAST调查的横断面观察研究

IF 1.6 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Brigita Skela-Savič, Tit Albreht, Walter Sermeus, Bojana Lobe, Mateja Bahun, Simon Dello
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引用次数: 1

摘要

导读:较高的护理工作量增加了患者死亡的几率,因为工作环境对患者的预后有显著影响。本研究旨在探讨医院护士工作环境与病人预后的关系。方法:收集斯洛文尼亚8家综合医院和2所大学医疗中心2019年外科患者出院的行政数据,以确定入院后30天内的住院死亡率。采用RN4CAST调查问卷收集这些医院护士的数据,共有1010名护士参与。数据是在2020年初收集的。计算每班护士人数及每班护患比。采用单因素、双因素和多因素统计方法对数据进行分析。结果:抽样医院手术患者住院30天死亡率为1.00%,范围为0.27% ~ 1.62%。人员配置的优势比表明,每个注册护士每增加一名患者,患者在入院后30天内死亡的可能性增加6%。平均患者/护士比率为15.56 (SD=2.50),变化范围为10.29 ~ 19.39。在检查的13项任务中,有4项在上一次轮班期间没有对患者执行。结论:结果并不令人鼓舞,注册护士极度短缺,因此注册护士的工作量很高。每个注册护士的病人数量在欧洲是最高的,也高于一些非欧洲国家,这对整个护理和保健质量构成了极大的风险。急性非急诊内科和外科的建议是每班4名注册护士。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Patient Outcomes and Hospital Nurses' Workload: A Cross-Sectional Observational Study in Slovenian Hospitals Using the RN4CAST Survey.

Introduction: Higher nursing workload increases the odds of patient deaths, as the work environment has a significant effect on patient outcomes. The aim of the study was to explore the relation between patient outcomes and nurses' working conditions in hospitals.

Methods: Administrative data on discharges of surgical patients for the year 2019 in eight general hospitals and two university medical centres in Slovenia were collected to determine in-hospital mortality within 30 days of admission. The RN4CAST survey questionnaire was used to gather data from nurses in these hospitals, with 1,010 nurses participating. Data was collected at the beginning of 2020. The number of nurses per shift and the nurse-to-patient ratio per shift were calculated. Univariate, bivariate and multivariate statistical methods were used to analyse the data.

Results: The 30-day in-hospital mortality for surgical patients was 1.00% in the hospitals sampled and ranged from 0.27% to 1.62%. The odds ratio for staffing suggests that each increase of one patient per RN is associated with a 6% increase in the likelihood of a patient dying within 30 days of admission. The mean patient-to-RN ratio was 15.56 (SD=2.50) and varied from 10.29 to 19.39. Four of the 13 tasks checked were not performed on patients during the last shift.

Conclusion: The results are not encouraging, with an extremely critical shortage of RNs and thus a high RN workload. The number of patients per RN is the highest in Europe and also higher than in some non-European countries, and represents an extreme risk to the quality of nursing and healthcare as a whole. The recommendation for acute non-emergency internal medicine and surgery departments is four patients per RN per shift.

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来源期刊
Zdravstveno Varstvo
Zdravstveno Varstvo PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
3.00
自引率
20.00%
发文量
30
审稿时长
23 weeks
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