Changes in patient and nurse outcomes associated with magnet hospital recognition.
Changes in patient and nurse outcomes associated with magnet hospital recognition.
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DOI：
10.1097/mlr.0000000000000355
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发表时间：
2015-06
期刊：
影响因子：
3
通讯作者：
Aiken LH
中科院分区：
文献类型：
--
作者：
Kutney-Lee A;Stimpfel AW;Sloane DM;Cimiotti JP;Quinn LW;Aiken LH
研究证明，磁铁医院与护士和患者的更好结果之间存在关联。然而，几乎没有纵向证据支持磁铁识别和结果之间的因果联系。为了比较1999至2007年间获得Magnet认证的医院样本中外科患者结果、护士报告的质量和护士结果随时间的变化，与仍未获得Magnet认可的医院进行比较。使用四个辅助数据源的两阶段回溯性面板设计。136家宾夕法尼亚州医院(11个“新兴”磁体和125个非磁体)美国护士认证中心磁体认可度；手术30天死亡率和抢救失败的风险调整比率、护士报告的质量指标和护士结果；护理工作指数固定效果差异模型的实践环境量表被用来比较新兴磁体医院和仍然没有磁体的医院之间的结果变化。与其他医院相比，新兴的Magnet医院在工作环境方面的改善明显更大。平均而言，在研究期间，新兴Magnet医院的30天手术死亡率和抢救失败率的变化比非Magnet医院更明显，每1000名患者死亡人数分别减少2.4人(p<；.01)和6.1人(p=0.02)。新出现的磁力医院和非磁力医院在护士报告的护理质量和护理结果方面的变化也有类似的差异。一般来说，Magnet认可与工作环境质量的显著改善以及患者和护士的结果超过非Magnet医院的显著改善有关。
Research has documented an association between Magnet hospitals and better outcomes for nurses and patients. However, little longitudinal evidence exists to support a causal link between Magnet recognition and outcomes. To compare changes over time in surgical patient outcomes, nurse-reported quality, and nurse outcomes in a sample of hospitals that attained Magnet recognition between 1999 and 2007 with hospitals that remained non-Magnet. Retrospective, two-stage panel design using four secondary data sources. 136 Pennsylvania hospitals (11 “emerging” Magnets and 125 non-Magnets) American Nurses Credentialing Center Magnet recognition; risk-adjusted rates of surgical 30-day mortality and failure-to-rescue, nurse-reported quality measures, and nurse outcomes; the Practice Environment Scale of the Nursing Work Index Fixed effects difference models were used to compare changes in outcomes between emerging Magnet hospitals and hospitals that remained non-Magnet. Emerging Magnet hospitals demonstrated markedly greater improvements in their work environments than other hospitals. On average, the changes in 30-day surgical mortality and failure-to-rescue rates over the study period were more pronounced in emerging Magnet hospitals than in non-Magnet hospitals, by 2.4 fewer deaths per 1000 patients (p<.01) and 6.1 fewer deaths per 1000 patients (p=0.02), respectively. Similar differences in the changes for emerging Magnet hospitals and non-Magnet hospitals were observed in nurse-reported quality of care and nurse outcomes. In general, Magnet recognition is associated with significant improvements over time in the quality of the work environment, and in patient and nurse outcomes that exceed those of non-Magnet hospitals.