Rural Hospital Nursing: Environment, Effects and Evidence

乡村医院护理：环境、影响和证据

• 批准号: 7335647
• 负责人: ROBIN P NEWHOUSE
• 金额: $ 10.83万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-01-01 至 2008-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7335647
• 关键词: Rural; Hospital; Nursing; Environment; Effects

Decreasing financial margins in rural hospitals and the potential impact on the quality of care are urgent concerns. Nursing care is directly related to quality, and is a basic essential core service for rural hospitals. The effects of legislative initiatives, service area and hospital characteristics on rural hospital nursing are unknown. The Agency for Healthcare Research and Quality and The Institute of Medicine have identified the rural population as a high priority for research. The overall objective of this proposed study is to evaluate the effects of legislative and market influences on rural nursing structure and patient outcomes. The specific aims are to: 1) Describe the impact of legislative changes and market influences on nursing in rural hospitals of various types; and 2) Examine the relationship between rural hospital nursing and patient outcomes. First, in a survey design, nurse executives (N=331) from rural hospitals for which quality outcomes are available will complete a telephone survey to describe the impact of legislative changes and market influences on nursing in rural hospitals. Second, nurse executive survey responses will be used in a cross-sectional correlational design to examine the impact of legislative changes and market influences on nursing in various types of rural hospitals. Third, a time-series design will be used to model changes over-time in financial margins on Registered Nurse Hours Per Patient Day (RNHPPD) and risk adjusted clinical outcomes [Health Care Utilization Project Quality Indicators (QIs) and Patient Safety Indicators (PSIs)], as well as the impact over time of RNHPPD on risk adjusted clinical outcomes (QIs and PSIs). Americans are faced with the dilemma of how to improve healthcare quality and safety, while creating a less wasteful and more efficient health system. This is an urgent priority for the rural population. This study has immediate significance for rural hospitals and rural hospital nursing through the identification of legislative, service area characteristics, hospital characteristics and nursing factors in rural hospitals that are related to quality of care. Study results will enable subsequent interventions to focus on improvement opportunities in rural hospitals. This project has promising potential to improve quality of care to the rural population using the novel approach of focusing on an understudied area, nursing in rural hospitals.

紧急的 关注。护理与质量直接相关，并且是农村医院的基本基本核心服务。 立法举措，服务区和医院特征对农村医院护理的影响 未知。医疗保健研究与质量机构以及医学研究所已经确定了 农村人口是研究的重点。 这项拟议的研究的总体目的是评估立法和市场影响的影响 关于农村护理结构和患者预后。具体目的是： 1）描述立法变更和市场影响对各种农村医院护理的影响 类型；和 2）检查农村医院护理与患者结局之间的关系。 首先，在调查设计中，护士高管（n = 331）来自农村医院 可用的将完成电话调查，以描述立法变更和市场影响的影响 关于乡村医院的护理。其次，护士执行调查回复将用于横截面 相关设计，以检查立法变化和市场影响对各种护理的影响 乡村医院的类型。第三，时间序列设计将用于建模财务上的变化 每天注册护士小时（RNHPPD）和风险调整后的临床结果的利润率[健康 护理利用项目质量指标（QIS）和患者安全指标（PSI）]以及影响 随着风险调整后的临床结果（QIS和PSI）的RNHPPD时间。 美国人面临着如何改善医疗保健质量和安全的困境，同时创建一个 浪费较低，更有效的卫生系统。对于农村人口而言，这是一个紧迫的优先事项。这项研究 通过识别，对农村医院和农村医院护理具有直接的意义 农村医院的立法，服务区特征，医院特征和护理因素 与护理质量有关。研究结果将使随后的干预措施专注于改进 农村医院的机会。该项目具有提高农村护理质量的潜力 人口使用新颖的方法，即专注于乡村医院的护理领域，护理。