Doctoral Dissertation Research: The Impact of Nurse Staffing on the Quality of Patient Care

9809464 LeClere本论文的目的是改进奖是评估医院护理人员的最新变化及其对患者护理质量的影响。检查的人员变化是每个急性调整患者日的护理人员水平和护理人员组合。质量是通过三个患者结局指标来衡量的：死亡率、再入院率和感染率。控制的因素包括患者的视力和医院特点。使用了三个二级数据集，其中两个来自1992-1996年宾夕法尼亚州所有医院的年度人员配置和使用记录，第三个来自这些医院同一时期的所有患者记录。使用两种方法来分析数据。反复横断面分析评估患者结果与护士人员配置的关系。时间序列分析评估在人员配置变化的情况下结果变化的百分比。这项研究具有紧迫的重要性。自1994年以来，护士和病人都感到人员配备水平和病人护理质量下降。然而，目前还没有对这些变化进行大规模的研究。过去的研究只是横断面的，关注的是病人的死亡率。1996年，医学研究所报告这一领域缺乏研究，并建议为其提供资金。

9809464 LeClere The objective of this dissertation improvement award is to assess the recent changes in hospital nursing staff and their impact on the quality of patient care. The staffing changes examined are levels of nursing staff per acuity-adjusted patient day, and nursing staff mix. Quality is measured through three patient outcomes indicators: mortality, readmissions and infection rates. Factors controlled for include patient acuity and hospital characteristics. Three secondary data sets are utilized, two from yearly staffing and utilization records from all Pennsylvania hospitals for 1992-1996, and the third from all patient records in these hospitals over the same period. Two methods are utilized to analyze the data. Repeated cross-sectional analysis assesses the relationship of patient outcomes to nurse staffing. Time series analysis assesses the percent change in outcomes given the changes in staffing. This research is of immediate importance. Since 1994, nurses and patients have perceived a decline in staffing levels and in the quality of patient care. Yet there has been no large-scale study of the changes. Past research has been cross-sectional only, focusing on patient mortality. In 1996, the Institute of Medicine reported a lack of research in this area and recommended its funding.