Nurse Staffing Patterns and Pediatric Quality of Care

描述（由申请人提供）：质量指标和护士配备

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.