Effects of hospital care environment on patient mortality and nurse outcomes
Effects of hospital care environment on patient mortality and nurse outcomes
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DOI：
10.1097/01.nna.0000312773.42352.d7
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发表时间：
2008-05-01
影响因子：
2
通讯作者：
Sloane, Douglas M.
中科院分区：
文献类型：
--
作者：
Aiken, Linda H.;Clarke, Sean P.;Sloane, Douglas M.
目的：本研究的目的是在考虑护士人员配置和教育后，分析护士实践环境对护士和患者结果的净影响。背景：人员配置和教育与患者治疗结果之间的关联已得到充分证明，但有关护理环境对治疗结果影响的证据却较为有限。方法：分析了宾夕法尼亚州 168 家医院的 10,184 名护士和 232,342 名手术患者的数据。使用护理工作指数的实践环境量表来衡量护理环境。结果包括护士工作满意度、倦怠、离职意向、护理质量报告以及患者死亡率和抢救失败情况。结果：护士报告了更积极的工作体验，对护理质量的担忧更少，在护理环境更好的医院中，患者死亡和抢救失败的风险显着降低。结论：护理环境要素必须与护士人员配置和教育一起优化，以实现高质量的护理。
Objective: The objective of this study was to analyze the net effects of nurse practice environments on nurse and patient outcomes after accounting for nurse staffing and education. Background: Staffing and education have welldocumented associations with patient outcomes, but evidence on the effect of care environments on outcomes has been more limited. Methods: Data from 10,184 nurses and 232,342 surgical patients in 168 Pennsylvania hospitals were analyzed. Care environments were measured using the practice environment scales of the Nursing Work Index. Outcomes included nurse job satisfaction, burnout, intent to leave, and reports of quality of care, as well as mortality and failure to rescue in patients.Results: Nurses reported more positive job experiences and fewer concerns with care quality, and patients had significantly lower risks of death and failure to rescue in hospitals with better care environments.Conclusion: Care environment elements must be optimized alongside nurse staffing and education to achieve high quality of care.