Nurse-Patient ratios - A systematic review on the effects of nurse staffing on patient, nurse employee, and hospital outcomes
Nurse-Patient ratios - A systematic review on the effects of nurse staffing on patient, nurse employee, and hospital outcomes
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DOI：
10.1097/00005110-200407000-00005
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发表时间：
2004-07-01
影响因子：
2
通讯作者：
Kravitz, RL
中科院分区：
文献类型：
--
作者：
Lang, TA;Hodge, M;Kravitz, RL
目的：确定同行评议的文献是否支持急诊医院特定的最低护患比例，以及护士人员配备是否与患者、护士员工或医院结果相关。背景：医院护理可能受到一些力量的影响，这些力量增加了患者的敏锐度，降低了护理员与患者的比例，并降低了这些护理员的培训水平。方法：我们系统地回顾了1980至2003年间发表的关于护士人员配备对患者、护士员工和医院结果的影响的研究，以确定它们是否可以指导急诊医院最低许可护患比例的设置。结果：在2897篇感兴趣的标题和摘要中，检索到490篇文章，符合纳入标准的有43家。尽管所有研究都根据病例组合和技能组合进行了调整，但最近只有一项研究涉及最低护士人员配置比例。患者的结果仅限于住院期间的不良事件。有证据表明，更丰富的护士配置与较低的抢救失败率、较低的住院死亡率和较短的住院时间相关。结论：文献没有支持急诊医院具体的最低护患比例，特别是在缺乏对技能和患者组合进行调整的情况下，尽管总护理时数和技能组合似乎确实影响了一些重要的患者结局。
Objective: To determine whether the peer-reviewed literature supports specific, minimum nurse-patient ratios for acute care hospitals and whether nurse staffing is associated with patient, nurse employee, or hospital outcomes.Background: Hospital care may be compromised by forces that have increased patient acuity, reduced the ratio of caregivers to patients, and lowered the level of training of these caregivers.Methods: We systematically reviewed studies of the effects of nurse staffing on patient, nurse employee, and hospital outcomes published between 1980 and 2003 to determine whether they could guide the setting of minimum licensed nurse-patient ratios in acute care hospitals.Results: Of 2897 titles and abstracts of interest, 490 articles were retrieved, and 43 met the inclusion criteria. Although all adjusted for case mix and skill mix, only one recent study addressed minimum nurse staffing ratios. Patient outcomes were limited to in-hospital, adverse events. Evidence suggests that richer nurse staffing is associated with lower failure-to-rescue rates, lower inpatient mortality rates, and shorter hospital stays.Conclusion: The literature offers no support for specific, minimum nurse-patient ratios for acute care hospitals, especially in the absence of adjustments for skill and patient mix, although total nursing hours and skill mix do appear to affect some important patient outcomes.