Nursing staff numbers and their relationship to conflict and containment rates on psychiatric wards-A cross sectional time series Poisson regression study
Nursing staff numbers and their relationship to conflict and containment rates on psychiatric wards-A cross sectional time series Poisson regression study
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DOI：
10.1016/j.ijnurstu.2011.07.005
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发表时间：
2012-01-01
影响因子：
8.1
通讯作者：
Crowder, Martin
中科院分区：
文献类型：
--
作者：
Bowers, Len;Crowder, Martin
背景：对于综合医院来说，积极的结果和合格的护士配备水平之间的联系已经建立。证据的人员配备水平和结果的精神卫生护理是更稀疏，矛盾和复杂的日常分配的工作人员资源病房与更严重的疾病patients.Objective：为了评估是否上升的人员人数之前或之后的水平的不良事件病房的精神病医院。设计：冲突事件总数中六个月期间轮班之间关系的时间序列分析（攻击、自我伤害、潜逃、吸毒/酗酒、拒绝服药）、全面遏制事件（临时用药、特殊观察、手动约束、武力展示、暂停、隔离、强制肌肉内用药）和护士人员配备水平。设置：32急性精神科病房在England.Methods：在每一个班次结束时，护士对参与病房完成了一份清单，报告的冲突和遏制事件的数量，和值班的护理人员的数量。结果：定期合格的护士人员配备水平在前面的班次正相关的冲突和遏制水平。冲突和遏制水平在前面的班次是不相关的护士人员配置levels.Conclusions：结果支持的解释，提高合格的护士人员配置水平导致不良事件的风险增加，而不良事件不会导致随之而来的工作人员增加。这些结果可能是可以解释的精神科护士对病人的权力。(C)2011爱思唯尔有限公司版权所有。
Background: The link between positive outcomes and qualified nurse staffing levels is well established for general hospitals. Evidence on staffing levels and outcomes for mental health nursing is more sparse, contradictory and complicated by the day to day allocation of staff resources to wards with more seriously ill patients.Objective: To assess whether rises in staffing numbers precede or follow levels of adverse incidents on the wards of psychiatric hospitals.Design: Time series analysis of the relationship between shift to shift changes over a six month period in total conflict incidents (aggression, self-harm, absconding, drug/alcohol use, medication refusal), total containment incidents (pro re nata medication, special observation, manual restraint, show of force, time out, seclusion, coerced intramuscular medication) and nurse staffing levels.Settings: 32 acute psychiatric wards in England.Methods: At the end of every shift, nurses on the participating wards completed a checklist reporting the numbers of conflict and containment incidents, and the numbers of nursing staff on duty.Results: Regular qualified nurse staffing levels in the preceding shifts were positively associated with raised conflict and containment levels. Conflict and containment levels in preceding shifts were not associated with nurse staffing levels.Conclusions: Results support the interpretation that raised qualified nurse staffing levels lead to small increases in risks of adverse incidents, whereas adverse incidents do not lead to consequent increases in staff. These results may be explicable in terms of the power held and exerted by psychiatric nurses in relation to patients. (C) 2011 Elsevier Ltd. All rights reserved.