Nursing care quality and adverse events in US hospitals
Nursing care quality and adverse events in US hospitals
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DOI：
10.1111/j.1365-2702.2010.03250.x
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发表时间：
2010-08-01
影响因子：
4.2
通讯作者：
Aiken, Linda H.
中科院分区：
文献类型：
--
作者：
Lucero, Robert J.;Lake, Eileen T.;Aiken, Linda H.
目的：研究护士报告的未满足的护理需求与他们报告的患者接受错误的药物或剂量，医院感染和患者福尔斯跌倒与医院受伤之间的关系。很少有研究涉及护理活动和患者结果之间的关联。设计：对1999年收集的10个样本的横断面数据进行二次分析，美国184名护士和168家急性护理医院。方法。考虑到患者因素和护理环境的影响，多元线性回归模型估计了未满足的护理需求对不良事件的影响。结果。未完成的必要护理比例范围从为患者和家人做好出院准备的26%到高达74%制定或更新护理计划。大多数护士报告说，患者接受了错误的药物或剂量，获得性院内感染，或有一个秋天的伤害很少。然而，报告这些不良事件频繁发生的护士差异很大[即用药错误（15%）、患者福尔斯跌倒受伤（20%）、院内感染（31%）]。在根据患者因素和护理环境进行调整后，未满足的护理需求与每起不良事件之间仍存在显著相关性。结论：研究结果表明，注意优化患者护理服务可以减少医院不良事件的发生。与临床实践相关。当护士完成需要他们花费时间的护理活动时，不良事件的发生可能会减轻与他们的病人。医院应该让护士参与制定影响人力资源管理的政策，以提高他们对护理环境和患者护理服务的认识。
Aim.To examine the association between nurses' reports of unmet nursing care needs and their reports of patients' receipt of the wrong medication or dose, nosocomial infections and patient falls with injury in hospitals.Background.Because nursing activities are often difficult to measure, and data are typically not collected by health care organisations, there are few studies that have addressed the association between nursing activities and patient outcomes.Design.Secondary analysis of cross-sectional data collected in 1999 from 10,184 staff nurses and 168 acute care hospitals in the US.Methods.Multivariate linear regression models estimated the effect of unmet nursing care needs on adverse events given the influence of patient factors and the care environment.Results.The proportion of necessary nursing care left undone ranged from 26% for preparing patients and families for discharge to as high as 74% for developing or updating nursing care plans. A majority of nurses reported that patients received the wrong medication or dose, acquired nosocomial infections, or had a fall with injury infrequently. However, nurses who reported that these adverse events occurred frequently varied considerably [i.e. medication errors (15%), patient falls with injury (20%), nosocomial infection (31%)]. After adjusting for patient factors and the care environment, there remained a significant association between unmet nursing care needs and each adverse event.Conclusion.The findings suggest that attention to optimising patient care delivery could result in a reduction in the occurrence of adverse events in hospitals.Relevance to clinical practice.The occurrence of adverse events may be mitigated when nurses complete care activities that require them to spend time with their patients. Hospitals should engage staff nurses in the creation of policies that influence human resources management to enhance their awareness of the care environment and patient care delivery.