Nurse-Patient Ratios as a Patient Safety Strategy A Systematic Review
Nurse-Patient Ratios as a Patient Safety Strategy A Systematic Review
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DOI：
10.7326/0003-4819-158-5-201303051-00007
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发表时间：
2013-03-05
影响因子：
39.2
通讯作者：
Shekelle, Paul G.
中科院分区：
文献类型：
--
作者：
Shekelle, Paul G.
一小部分病人在住院期间或住院后不久死亡，人们普遍认为，更多或更好的护理可以防止其中一些死亡。作者系统地回顾了截至2012年9月有关护士人员比例和住院死亡的证据。从550个标题中，对87篇文章进行了综述，并选择了15项新研究，这些研究补充了2项现有综述。最有力的证据支持较高的护士配备水平和降低住院死亡率之间的因果关系来自一个纵向研究，在一家医院，仔细考虑护士配备和患者共病条件和荟萃分析，发现了“剂量反应关系”的观察性研究护士配备和死亡。没有研究报告与护士人数增加相关的任何严重伤害。限制任何更强有力的结论是缺乏评估的干预措施，以增加护士的工作人员比例。增加护患比的正式成本无法计算，因为没有评估护士人员配置的故意变化，以改善患者的结果。Ann Intern Med.2013;158：404-409. www.annals.org
A small percentage of patients die during hospitalization or shortly thereafter, and it is widely believed that more or better nursing care could prevent some of these deaths. The author systematically reviewed the evidence about nurse staffing ratios and in-hospital death through September 2012. From 550 titles, 87 articles were reviewed and 15 new studies that augmented the 2 existing reviews were selected. The strongest evidence supporting a causal relationship between higher nurse staffing levels and decreased inpatient mortality comes from a longitudinal study in a single hospital that carefully accounted for nurse staffing and patient comorbid conditions and a meta-analysis that found a "dose-response relationship" in observational studies of nurse staffing and death. No studies reported any serious harms associated with an increase in nurse staffing. Limiting any stronger conclusions is the lack of an evaluation of an intervention to increase nurse staffing ratios. The formal costs of increasing the nurse-patient ratio cannot be calculated because there has been no evaluation of an intentional change in nurse staffing to improve patient outcomes. Ann Intern Med. 2013;158:404-409. www.annals.org