Hospital nurse practice environments and outcomes for surgical oncology patients.
Hospital nurse practice environments and outcomes for surgical oncology patients.
复制标题
外科肿瘤患者的医院护士练习环境和结果。
DOI：
10.1111/j.1475-6773.2007.00825.x
复制
发表时间：
2008-08
影响因子：
3.4
通讯作者：
Sochalski, Julie
中科院分区：
文献类型：
--
作者：
Friese, Christopher R.;Lake, Eileen T.;Aiken, Linda H.;Silber, Jeffrey H.;Sochalski, Julie
关键词：
探讨护理实习环境对住院癌症手术病人预后之影响。对1998-1999年在宾夕法尼亚州收集的癌症登记、住院病人索赔、行政和护士调查数据进行二次分析。护士的人员配置（病人与护士的比例），教育准备（护士持有至少学士学位的比例），和实践环境（实践环境规模的护理工作指数）的护士的调查计算和汇总到医院的水平。Logistic回归模型预测了30天死亡率、并发症和抢救失败（并发症后死亡）的几率。未校正的死亡、并发症和抢救失败率分别为3.4%、35.7%和9.3%。护士配备和注册护士的教育准备与病人的结果显着相关。在对患者和医院特征进行调整后，在护士执业环境较差的医院中，患者的死亡几率（比值比，1.37; 95%置信区间，1.07-1.76）和抢救失败几率（比值比，1.48; 95%置信区间，1.07-2.03）显著增加。在国家癌症研究所指定的癌症中心接受护理显着降低了死亡几率，这可以部分解释为更好的护士实践环境。这项研究是第一个检查的预测有效性的国家质量论坛的认可措施的护士执业环境。护士执业环境质量的改善可以减少住院外科肿瘤患者的不良后果。
To examine the effect of nursing practice environments on outcomes of hospitalized cancer patients undergoing surgery. Secondary analysis of cancer registry, inpatient claims, administrative and nurse survey data collected in Pennsylvania for 1998–1999. Nurse staffing (patient to nurse ratio), educational preparation (proportion of nurses holding at least a bachelor’s degree), and the practice environment (Practice Environment Scale of the Nursing Work Index) were calculated from a survey of nurses and aggregated to the hospital level. Logistic regression models predicted the odds of 30-day mortality, complications, and failure to rescue (death following a complication). Unadjusted death, complication, and failure to rescue rates were 3.4, 35.7, and 9.3 percent, respectively. Nurse staffing and educational preparation of registered nurses were significantly associated with patient outcomes. After adjusting for patient and hospital characteristics, patients in hospitals with poor nurse practice environments had significantly increased odds of death (odds ratio, 1.37; 95 percent confidence interval, 1.07–1.76) and of failure to rescue (odds ratio, 1.48; 95 percent confidence interval, 1.07–2.03). Receipt of care in National Cancer Institute-designated cancer centers significantly decreased the odds of death, which can be explained partly by better nurse practice environments. This study is one of the first to examine the predictive validity of the National Quality Forum’s endorsed measure of the nurse practice environment. Improvements in the quality of nurse practice environments could reduce adverse outcomes for hospitalized surgical oncology patients.
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影响因子：
120.7
作者：
Aiken, LH;Clarke, SP;Silber, JH
通讯作者：
Silber, JH
影响因子：
1.9
作者：
Friese, CR
通讯作者：
Friese, CR
影响因子：
3
作者：
Aiken, LH;Sloane, DM;Weber, AL
通讯作者：
Weber, AL
DOI：
10.1093/jnci/95.10.708
发表时间：
2003-05-21
期刊：
JOURNAL OF THE NATIONAL CANCER INSTITUTE
影响因子：
--
作者：
Hodgson, DC;Zhang, W;Ayanian, JZ
通讯作者：
Ayanian, JZ
影响因子：
9.7
作者：
Ayanian, JZ;Weissman, JS;Epstein, AM
通讯作者：
Epstein, AM