ORIGINAL RESEARCH Nurses' Presenteeism and Its Effects on Self-Reported Quality of Care and Costs
ORIGINAL RESEARCH Nurses' Presenteeism and Its Effects on Self-Reported Quality of Care and Costs
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DOI：
10.1097/01.naj.0000411176.15696.f9
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发表时间：
2012-02-01
影响因子：
2.7
通讯作者：
Gupta, Sat N.
中科院分区：
文献类型：
--
作者：
Letvak, Susan A.;Ruhm, Christopher J.;Gupta, Sat N.
目的：虽然研究已经进行了护士的人员配置水平如何影响结果，很少有调查如何与健康相关的生产力的护士是与护理质量。工人出勤率（由于健康问题导致的工作生产率降低）的两个主要原因是肌肉骨骼疼痛和心理健康问题，特别是抑郁症。本研究旨在探讨在何种程度上肌肉骨骼疼痛或抑郁症（或两者）在RNs影响他们的工作效率和自我报告的护理质量，并考虑了相关costs.Methods：采用横断面调查设计，随机抽样的2,500名医院雇用的RNs许可在北卡罗来纳州进行了调查，使用通过邮寄的调查工具。具体措施包括个人和工作场所的特点，自我报告的护理质量和病人的安全问题，数字疼痛评分量表，抑郁症的工具（患者健康问卷），和出勤工具（工作效率和活动障碍问卷：一般健康）也被纳入。结果：在受访者中，肌肉骨骼疼痛的患病率为71%，抑郁症的患病率为18%。大多数受访者（62%）报告出勤率在0到10分的范围内至少为1分，表明健康问题至少“一点点”影响了工作效率。“疼痛和抑郁与出勤率显著相关。存在主义与较高的患者福尔斯跌倒次数、较高的用药错误次数和较低的护理质量评分显著相关。基线成本估计表明，出勤率导致的福尔斯和用药错误的增加预计将使每个北卡罗来纳州RN每年花费1,346美元，而美国每年花费不到20亿美元。上限估计超过9,000美元每北卡罗来纳州RN和13亿美元的nations.Conclusion：必须更加重视护理队伍的健康，积极影响病人护理和病人安全的质量和控制成本。
Objective: Although research has been conducted on how nurse staffing levels affect outcomes, there has been little investigation into how the health-related productivity of nurses is related to quality of care. Two major causes of worker presenteeism (reduced on-the-job productivity as a result of health problems) are musculoskeletal pain and mental health issues, particularly depression. This study sought to investigate the extent to which musculoskeletal pain or depression (or both) in RNs affects their work productivity and self-reported quality of care and considered the associated costs.Methods: Using a cross-sectional survey design, a random sample of 2,500 hospital-employed RNs licensed in North Carolina were surveyed using a survey instrument sent by postal mail. Specific measures included questions on individual and workplace characteristics, self-reported quality of care, and patient safety; a numeric pain rating scale, a depression tool (the Patient Health Questionnaire), and a presenteeism tool (the Work Productivity and Activity Impairment Questionnaire: General Health) were also incorporated. A total of 1,171 completed surveys were returned and used for analysis.Results: Among respondents, the prevalence of musculoskeletal pain was 71%; that of depression was 18%. The majority of respondents (62%) reported a presenteeism score of at least 1 on a 0-to-10 scale, indicating that health problems had affected work productivity at least "a little." Pain and depression were significantly associated with presenteeism. Presenteeism was significantly associated with a higher number of patient falls, a higher number of medication errors, and lower quality-of-care scores. Baseline cost estimates indicate that the increased falls and medication errors caused by presenteeism are expected to cost $1,346 per North Carolina RN and just under $2 billion for the United States annually. Upper-boundary estimates exceed $9,000 per North Carolina RN and $13 billion for the nation annually.Conclusion: More attention must be paid to the health of the nursing workforce to positively influence the quality of patient care and patient safety and to control costs.