Unit Level Nurse Workload Impacts on Patient Safety

单位级护士工作量对患者安全的影响

• 批准号: 6454916
• 负责人: NANCY E DONALDSON
• 金额: $ 39.41万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-30 至 2003-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6454916
• 关键词: clinical research; hospital patient care; human subject; nurse performance; nurses; nursing care evaluation

DESCRIPTION (APPLICATION ABSTRACT): The aims of this proposed two-year descriptive correlational study build on the established integrity and capacity of the California Nursing Outcomes Coalition (CalNOC) to engage California acute care hospitals in voluntarily using ANA nursing quality indicators for reporting standardized nurse staffing, patient safety, and quality indicators in a collaborative research, repository development, and benchmarking project. For the purposes of this study, it is posited that the daily unit-level configuration of nurse staffing and workload may buffer patients from the effects of error and resulting injury or compromise patient safety when variance in these factors exceeds a staff's adaptive capacity and breaches a unit-level margin of safety. The aims of this study are grounded in the knowledge that the potential to compromise patient safety through human error is inherent in nursing practice and medical care (IOM, 1999; QUIC, 2000; Reason, 1990). In collaboration with CalNOC's Statewide voluntary-convenience sample of medical-surgical acute care units from 77 hospitals, this study will break new ground in tracing daily unit-level direct care nurse staffing, in 100 patient care units over a two-month period, to examine associations between the structure of hospital nurse staffing and authoritative indicators of patient outcomes and safety commonly tracked by acute care hospitals, as well as regulatory and accreditation agencies--falls, pressure ulcers, restraint prevalence, and significant clinical events. Staffing measures to be studied include hours of direct care per patient day, skill mix of nurse caregivers, percent of contacted or agency staff, ratio of required to actual hours of care, and RN years of post-licensure experience. This study recognizes and quantifies the impact of patient turnover, a key factor in nurse staffing workload, and integrates it into multiple regression analyses examining associations between nurse staffing and outcomes. Of equal importance, this study will advance staffing measurement by tracing and analyzing the impact of variation in staffing and patient turnover, exploring the impact of variance on patient safety and outcomes.

描述（应用摘要）：本拟议两年期的目标 描述性相关研究建立在既定的完整性和 加州护理成果联盟（CalNOC）的参与能力 加州急症护理医院自愿使用ANA护理质量调查 报告标准化护士配备、患者安全的指标，以及 合作研究、知识库开发中的质量指标， 基准项目。 为了本研究的目的，假设 护士人员配置和工作量的日常单位级配置可能会缓冲 使患者免受错误的影响，并导致患者受伤或妥协 当这些因素的差异超过工作人员的适应能力时， 突破了单位级别的安全边际 本研究的目的是基于 在知识的潜在危害患者的安全，通过人类 错误是护理实践和医疗护理中固有的（IOM，1999; QUIC，2000; Reason，1990）。 与加州国家石油公司的全州非营利组织合作， 来自77家医院的内外科急症室样本，本研究将 在追踪单位一级直接护理护士的日常配置方面开辟了新的天地， 在两个月的时间里，100个病人护理单位， 医院护士配置结构与权威指标之间的关系 急性护理医院通常跟踪的患者结局和安全性， 以及监管和认证机构--福尔斯，压力性溃疡， 限制流行和重大临床事件。 人员配置措施， 研究包括每个病人每天的直接护理时间，护士的技能组合， 照顾者，接触或机构工作人员的百分比，需要与实际的比率 护理时间和RN年的执照后经验。 本研究 认识到并量化患者周转率的影响，这是 护士工作量，并将其纳入多元回归分析 检查护士配备和结果之间的关联。 平等 重要的是，这项研究将通过追踪和 分析人员配置和患者周转率变化的影响， 方差对患者安全性和结局的影响。