A cross-sectional study of 'care left undone' on nursing shifts in hospitals
A cross-sectional study of 'care left undone' on nursing shifts in hospitals
复制标题
DOI：
10.1111/jan.12976
复制
发表时间：
2016-09-01
影响因子：
3.8
通讯作者：
Tishelman, Carol
中科院分区：
文献类型：
--
作者：
Ball, Jane E.;Griffiths, Peter;Tishelman, Carol
目标。为了确定与瑞典急性病房中注册护士（RN）的“未完成护理”（也称为“错过护理”）变化相关的因素。“未完成的护理”已被研究为一个因素，调解护士配备和病人的结果之间的关系。上下文以前没有被探索，以确定哪些其他因素与RNs. Design的“未完成的护理”的变化相关。采用多水平Logistic回归分析探讨RN人员配备与相关因素（如轮班时间、护理角色和患者对“未完成护理”的敏感度/依赖性）之间的关系。一项对瑞典79家急诊医院普通内科和外科病房的10，174名注册护士的调查（2010年1 - 3月）。74%的护士报告说，在上一次轮班时，有些护理工作没有完成。轮班时间、病人组合、护士角色、实习环境及人员配备与未完成照护有显著关系。护理未完成的几率在RN护理6名或更少患者的轮班中比护理10名或更多患者的轮班减少一半。先前观察到的RN人员配置和护理之间的关系被证实。护理未完成的报告受到RN角色的影响。辅助工作人员的配置几乎没有影响。需要研究来确定这些因素如何相互关联，以及未完成的护理是否是患者不良结局的预测因素。
Aims. To determine factors associated with variation in 'care left undone' (also referred to as 'missed care') by Registered Nurses (RNs) in acute hospital wards in Sweden.Background. 'Care left undone' has been examined as a factor mediating the relationship between nurse staffing and patient outcomes. The context has not previously been explored to determine what other factors are associated with variation in 'care left undone' by RNs.Design. Cross-sectional survey to explore the association of RN staffing and contextual factors such as time of shift, nursing role and patient acuity/dependency on 'care left undone' was examined using multi-level logistic regression.Methods. A survey of 10,174 RNs working on general medical and surgical wards in 79 acute care hospitals in Sweden (January-March 2010).Results. Seventy-four per cent of nurses reported some care was left undone on their last shift. The time of shift, patient mix, nurses' role, practice environment and staffing have a significant relationship with care left undone. The odds of care being left undone is halved on shifts where RN care for six patients or fewer compared with shifts where they care for 10 or more.Conclusion. The previously observed relationship between RN staffing and care left undone is confirmed. Reports of care left undone are influenced by RN roles. Support worker staffing has little effect. Research is needed to identify how these factors relate to one another and whether care left undone is a predictor of adverse patient outcomes.