Nurse Staffing Patterns and Pediatric Quality of Care

描述（由申请人提供）：质量和护士配备指标 在儿科与成人不同， 发展和依赖因素，不同的流行病学，以及不同的 儿童与成人保健服务系统的目标。目前没有 已被确认为护理质量的儿科健康状况指标 对所提供护理质量差异敏感的措施。内 一套长期目标，包括（a）审查各项进程， 儿科护理提供系统的结果;（B）识别和 验证儿科优质护理指标，以及（c）制定和 传播儿科护理实践的质量健康结果模型， 本研究的目的是确定儿童 急诊护理中的护士配备和儿科护理质量指标 设置.本研究的具体目的是（a）描述护士配备 用于儿科（每个患者日的总小时数、工作人员组合和经验）， （B）确定单位类型（内科、外科和重症监护）; 护士配备与儿科优质护理指标之间的关系 （不良事件、父母投诉、转入重症监护室或死亡） 医院获得性并发症），同时控制患者 严重性，以及（c）确定组织，病人护理单位和护理 这些特征有助于护士提供优质护理的能力。一 描述性相关设计将使用临床和管理数据， 从24个病人护理单位（16个）中的每一个回顾性收集 内科/外科和8个重症监护）从四个学术儿童 医院的一个日历年每个季度的数据将用于描述 儿科护理质量指标与护理人员的关系 通过多变量分析。

DESCRIPTION (provided by applicant): Indicators of quality and nurse staffing in pediatrics are distinct from that of adults due to differences in developmental and dependency factors, differential epidemiology, and different goals of child versus adult health services systems. Currently, there are no pediatric health status measures that have been validated as quality of care measures sensitive to differences in the quality of care delivered. Within a set of long-term objectives that include (a) examining the processes and outcomes of pediatric nursing care delivery systems; (b) identifying and validating indicators of quality care in pediatrics, and (c) developing and disseminating a quality health outcomes model for pediatric nursing practice, the purpose of this study is to determine the relationship between pediatric nurse staffing and pediatric quality of care indicators in the acute care setting. The specific aims of this study are (a) to describe nurse staffing used in pediatrics (total hours per patient day, staff mix and experience) by unit type (medical, surgical and intensive care); (b) identify the relationships between nurse staffing and pediatric indicators of quality care (adverse occurrences, parent complaints; transfers to intensive care or death following a hospital-acquired complication) while controlling for patient severity, and (c) to identify organizational, patient care unit, and nursing characteristics contribute to the nurse's ability to provide quality care. A descriptive correlational design will use clinical and administrative data, collected retrospectively, from each of 24 patient care units (16 medical/surgical and 8 intensive care) obtained from four academic Children's Hospitals. Data for each quarter of one calendar year will be used to describe the relationships between pediatric indicators of quality of care and nurse staffing through multivariate analyses.