Nurse Staffing Patterns and Pediatric Quality of Care

描述(由申请人提供)：质量指标和护士配置 儿科的与成人的不同，因为 发育和依赖因素、不同的流行病学和不同的 儿童与成人健康服务系统的目标。目前，没有 已被确认为护理质量的儿科健康状况衡量标准 对提供的护理质量差异敏感的措施。在一个 一套长期目标，包括(A)审查进程和 儿科护理提供系统的结果；(B)确定和 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高质量健康结果模型， 本研究的目的是确定儿科儿童与健康的关系。 急诊护理中的护士配置与儿科护理质量指标 布景。这项研究的具体目的是(A)描述护士的人员配置 用于儿科(每名患者每天的总小时数、员工组合和经验) 病房类型(内科、外科和重症监护)；(B)确定 护理人员配置与儿科质量护理指标的关系 (不良事件、父母投诉、转入重症监护室或死亡 医院获得性并发症之后)，同时控制患者 严重性，以及(C)确定组织、患者护理单位和护理 特质有助于护士提供优质护理的能力。一个 描述性相关设计将使用临床和管理数据， 从24个患者护理单元(16个)中的每个单元回溯收集 内科/外科和8个重症监护)从四个学术儿童 医院。将使用一历年每个季度的数据来描述 儿科护理质量指标与护士的关系 通过多变量分析进行人员配置。

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.