Nurse-staffing levels and the quality of care in hospitals
Nurse-staffing levels and the quality of care in hospitals
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DOI：
10.1056/nejmsa012247
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发表时间：
2002-05-30
影响因子：
158.5
通讯作者：
Zelevinsky, K
中科院分区：
文献类型：
--
作者：
Needleman, J;Buerhaus, P;Zelevinsky, K
背景资料：目前还不确定医院护士配备水平较低是否与患者出现并发症或死亡的风险增加有关。方法：我们使用了1997年11个州799家医院的管理数据（包括5，075，969名出院病人及1，104名659例外科患者出院），以检查医院护士提供的护理量与患者结局之间的关系。我们进行了回归分析，其中我们控制了患者的不良后果的风险，在每个医院的患者所需的护理，和其他variable.Results的差异：平均每病人一天的护理小时数为11.4，其中注册护士提供7.8小时，1.2小时的执业护士，2.4小时的护士助手。在内科患者中，注册护士每天提供的护理小时数比例较高，注册护士每天提供的护理小时数绝对值较高，与住院时间较短相关（P=0.01和P
Background: It is uncertain whether lower levels of staffing by nurses at hospitals are associated with an increased risk that patients will have complications or die.Methods: We used administrative data from 1997 for 799 hospitals in 11 states (covering 5,075,969 discharges of medical patients and 1,104,659 discharges of surgical patients) to examine the relation between the amount of care provided by nurses at the hospital and patients' outcomes. We conducted regression analyses in which we controlled for patients' risk of adverse outcomes, differences in the nursing care needed for each hospital's patients, and other variables.Results: The mean number of hours of nursing care per patient-day was 11.4, of which 7.8 hours were provided by registered nurses, 1.2 hours by licensed practical nurses, and 2.4 hours by nurses' aides. Among medical patients, a higher proportion of hours of care per day provided by registered nurses and a greater absolute number of hours of care per day provided by registered nurses were associated with a shorter length of stay (P=0.01 and P