Hospital nurse staffing: choice of measure matters.
Hospital nurse staffing: choice of measure matters.
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DOI：
10.1097/mlr.0b013e318222a6df
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发表时间：
2011-08
期刊：
影响因子：
3
通讯作者：
Rochman M
中科院分区：
文献类型：
--
作者：
Kalisch BJ;Friese CR;Choi SH;Rochman M
研究人员经常使用护士配备的措施来检查医院的护理质量。测量选择包括护士报告的人员配备充足性，护士报告的患者工作量，以及每患者日的工作时间（HPPD）。检查这些措施之间的相关性，并确定与这些人员配置措施相关的因素。对11所急诊医院92名内科-外科、康复和中级患者的横断面相关性研究。我们调查了注册护士对他们的感知人员配备充足，最后一班病人的工作量，单位级的结构和护理提供过程。个人对这些措施的反应汇总到护理单元的水平，和单位级HPPD，单位级病例组合指数（CMI）从每个医院的行政数据。在检查了各变量之间的相关矩阵后，使用线性回归对与三项人员配置措施相关的变量进行了检查。HPPD与护士报告的最后一班病人工作量相关（r=-0.276，p=.008），对人员配备充足性的看法与护士报告的最后一班病人工作量相关（r=-0.384，p=.000）。在多变量分析中，辅助人员数量不足与感知的人员配备充足性和护士报告的患者负荷显著相关。单元级CMI与HPPD和护士报告的患者负荷显著相关。这些数据表明，这三个措施的护士配备并不高度相关，并可能会捕获不同的元素的单位背景下，解释护士配备。研究人员应考虑这些措施的相关性时，选择护士的人员配备措施，为今后的调查。
Researchers frequently use nurse staffing measures to examine hospital quality of care. Measure choices include nurse-reported perception of staffing adequacy, nurse-reported patient workloads, and empirically-derived hours per patient day (HPPD). To examine the correlations across these measures and identify factors associated with these staffing measures. A cross-sectional correlational study of 92 medical-surgical, rehabilitation, and intermediate in 11 acute care hospitals. We surveyed registered nurses on their perceived staffing adequacy, last shift patient workload, and unit-level structures and processes of care delivery. Individual responses to these measures were aggregated to the nursing unit level, and unit-level HPPD, unit-level case mix index (CMI) were obtained from each hospital’s administrative data. After examining the correlation matrix across variables, those associated with the three staffing measures were then examined using linear regression. HPPD and the nurse-reported patient workload on last shift were correlated (r=−.276, p=.008), and perceptions of the adequacy of staffing and nurse-reported patient workload on last shift were correlated (r=−.384, p=.000). In multivariable analyses, inadequate numbers of assistive personnel was significantly associated with both perceived staffing adequacy and nurse-reported patient loads. Unit-level CMI was significantly associated with both HPPD and nurse-reported patient loads. These data suggest that the three measures of nurse staffing are not highly correlated, and may capture different elements of the unit context to explain nurse staffing. Researchers should consider the correlates of these measures when selecting nurse staffing measures for future investigations.