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International Journal of Nursing Studies:护士人力配置与住院患者死亡率之间的关系

2021-10-03 小文子 MedSci原创

注册护士人员配置水平与死亡率之间存在相关性,注册护士的级别越高,患者的预后越好。

几十年来,护理人力资源配置与患者预后之间的关系一直备受关注。护理人力资源配置与患者跌倒、医院感染和护理相关并发症有关。

发表在International Journal of Nursing Studies杂志的一篇文章,探索暴露于较低或较高级别注册护士/护理助理轮班时,患者的死亡率。

这项纵向研究使用瑞士一所大学医院三年(2015-2017年)的常规轮班、病房和患者水平数据。对55个病房、79893名成人住院患者和3646名护士(2670名注册护士、438名职业护士和538名助理护士和管理人员)的数据进行分析。开发人员配置模型确定高级别和低级别护士轮班后,研究人员拟合逻辑回归模型探索护士配置与死亡率之间的关系。

结果显示,暴露于高级别注册护士的轮班工作,患者死亡率降低8.7% [OR=0.91, 95%CI, 0.89-0.93]。相反,低级别注册护士轮班与10%的高死亡率相关[OR=1.10, 95%CI, 1.07–1.13]。其他群体人员轮班与死亡率之间的具体关系仍不清楚。例如,助理护士和管理人员的高级别和低级别配置均与较高死亡率相关,分别为1.03 [95%CI, 1.01–1.04]和1.04[95%CI, 1.03-1.06]。

患者水平的纵向研究表明,注册护士人员配置水平与死亡率之间存在相关性,注册护士的级别越高,患者的预后越好(即死亡率越低),而级别越低,患者的预后越差(即死亡率越高)。从这些结果来看,其他三组对患者的安全性尚不清楚。因此,不建议任何一组来替代注册护士。研究人员认为,迫切需要研究合理的护士配置方案。

原文出处:

Sarah N. Musya, Olga Endrich,et al, The association between nurse staffing and inpatient mortality: A
shift-level retrospective longitudinal study, 2021, International Journal of Nursing Studies, https://doi.org/10.1016/j.ijnurstu.2021.103950

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    2022-08-03 liye789132251
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  5. [GetPortalCommentsPageByObjectIdResponse(id=2008801, encodeId=498c200880164, content=<a href='/topic/show?id=db6969548d' target=_blank style='color:#2F92EE;'>#eRNA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6954, encryptionId=db6969548d, topicName=eRNA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Sun Apr 24 13:31:36 CST 2022, time=2022-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1795186, encodeId=79af1e9518660, content=<a href='/topic/show?id=d8261685684' target=_blank style='color:#2F92EE;'>#studies#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16856, encryptionId=d8261685684, topicName=studies)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0a27288, createdName=smallant2002, createdTime=Sat Jul 23 10:31:36 CST 2022, time=2022-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1885422, encodeId=9e97188542218, content=<a href='/topic/show?id=3b2112532d8' target=_blank style='color:#2F92EE;'>#Nat#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12532, encryptionId=3b2112532d8, topicName=Nat)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e6f107, createdName=liye789132251, createdTime=Wed Aug 03 13:31:36 CST 2022, time=2022-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1983742, encodeId=ab501983e4248, content=<a href='/topic/show?id=628553048e3' target=_blank style='color:#2F92EE;'>#患者死亡#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53048, encryptionId=628553048e3, topicName=患者死亡)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Sat May 28 17:31:36 CST 2022, time=2022-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1569673, encodeId=1edd15696e315, content=<a href='/topic/show?id=961b5945dd' target=_blank style='color:#2F92EE;'>#DIE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5945, encryptionId=961b5945dd, topicName=DIE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d76015553894, createdName=lg.zhao, createdTime=Tue Oct 05 13:31:36 CST 2021, time=2021-10-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1057415, encodeId=81f6105e4156b, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a5285563859, createdName=ms4000001818885394, createdTime=Mon Oct 04 09:29:23 CST 2021, time=2021-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1057295, encodeId=c826105e295d7, content=迫切需要研究合理的护士配置方案, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTInOuicIVN8Y32NO4Q53Zpd86ObmNp2WIotichCD0qQHaUBeHj7hgwQBCzX7ce4aEw5ZP8icQQfLH9Zw/132, createdBy=4ec21734756, createdName=1def6e10m76(暂无匿称), createdTime=Mon Oct 04 06:46:49 CST 2021, time=2021-10-04, status=1, ipAttribution=)]
    2021-10-05 lg.zhao
  6. [GetPortalCommentsPageByObjectIdResponse(id=2008801, encodeId=498c200880164, content=<a href='/topic/show?id=db6969548d' target=_blank style='color:#2F92EE;'>#eRNA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6954, encryptionId=db6969548d, topicName=eRNA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Sun Apr 24 13:31:36 CST 2022, time=2022-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1795186, encodeId=79af1e9518660, content=<a href='/topic/show?id=d8261685684' target=_blank style='color:#2F92EE;'>#studies#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16856, encryptionId=d8261685684, topicName=studies)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0a27288, createdName=smallant2002, createdTime=Sat Jul 23 10:31:36 CST 2022, time=2022-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1885422, encodeId=9e97188542218, content=<a href='/topic/show?id=3b2112532d8' target=_blank style='color:#2F92EE;'>#Nat#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12532, encryptionId=3b2112532d8, topicName=Nat)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e6f107, createdName=liye789132251, createdTime=Wed Aug 03 13:31:36 CST 2022, time=2022-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1983742, encodeId=ab501983e4248, content=<a href='/topic/show?id=628553048e3' target=_blank style='color:#2F92EE;'>#患者死亡#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53048, encryptionId=628553048e3, topicName=患者死亡)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Sat May 28 17:31:36 CST 2022, time=2022-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1569673, encodeId=1edd15696e315, content=<a href='/topic/show?id=961b5945dd' target=_blank style='color:#2F92EE;'>#DIE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5945, encryptionId=961b5945dd, topicName=DIE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d76015553894, createdName=lg.zhao, createdTime=Tue Oct 05 13:31:36 CST 2021, time=2021-10-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1057415, encodeId=81f6105e4156b, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a5285563859, createdName=ms4000001818885394, createdTime=Mon Oct 04 09:29:23 CST 2021, time=2021-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1057295, encodeId=c826105e295d7, content=迫切需要研究合理的护士配置方案, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTInOuicIVN8Y32NO4Q53Zpd86ObmNp2WIotichCD0qQHaUBeHj7hgwQBCzX7ce4aEw5ZP8icQQfLH9Zw/132, createdBy=4ec21734756, createdName=1def6e10m76(暂无匿称), createdTime=Mon Oct 04 06:46:49 CST 2021, time=2021-10-04, status=1, ipAttribution=)]
    2021-10-04 ms4000001818885394

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=2008801, encodeId=498c200880164, content=<a href='/topic/show?id=db6969548d' target=_blank style='color:#2F92EE;'>#eRNA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6954, encryptionId=db6969548d, topicName=eRNA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Sun Apr 24 13:31:36 CST 2022, time=2022-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1795186, encodeId=79af1e9518660, content=<a href='/topic/show?id=d8261685684' target=_blank style='color:#2F92EE;'>#studies#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16856, encryptionId=d8261685684, topicName=studies)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0a27288, createdName=smallant2002, createdTime=Sat Jul 23 10:31:36 CST 2022, time=2022-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1885422, encodeId=9e97188542218, content=<a href='/topic/show?id=3b2112532d8' target=_blank style='color:#2F92EE;'>#Nat#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12532, encryptionId=3b2112532d8, topicName=Nat)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e6f107, createdName=liye789132251, createdTime=Wed Aug 03 13:31:36 CST 2022, time=2022-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1983742, encodeId=ab501983e4248, content=<a href='/topic/show?id=628553048e3' target=_blank style='color:#2F92EE;'>#患者死亡#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53048, encryptionId=628553048e3, topicName=患者死亡)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Sat May 28 17:31:36 CST 2022, time=2022-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1569673, encodeId=1edd15696e315, content=<a href='/topic/show?id=961b5945dd' target=_blank style='color:#2F92EE;'>#DIE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5945, encryptionId=961b5945dd, topicName=DIE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d76015553894, createdName=lg.zhao, createdTime=Tue Oct 05 13:31:36 CST 2021, time=2021-10-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1057415, encodeId=81f6105e4156b, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a5285563859, createdName=ms4000001818885394, createdTime=Mon Oct 04 09:29:23 CST 2021, time=2021-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1057295, encodeId=c826105e295d7, content=迫切需要研究合理的护士配置方案, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTInOuicIVN8Y32NO4Q53Zpd86ObmNp2WIotichCD0qQHaUBeHj7hgwQBCzX7ce4aEw5ZP8icQQfLH9Zw/132, createdBy=4ec21734756, createdName=1def6e10m76(暂无匿称), createdTime=Mon Oct 04 06:46:49 CST 2021, time=2021-10-04, status=1, ipAttribution=)]
    2021-10-04 1def6e10m76(暂无匿称)

    迫切需要研究合理的护士配置方案

    0

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德国一项研究表明,冠脉支架置入后随访造影检出的再狭窄可预测患者4年死亡率。论文10月8日在线发表于《欧洲心脏杂志》(Eur Heart J)。 此项研究共纳入10004例因新发病变成功置入冠脉支架并在6~8个月后接受常规对照造影的患者,并以随访造影时节段区域内直径狭窄≥50%定义再狭窄。主要转归为4年死亡率。评估再再狭窄对4年死亡的影响。 结果显示,2643例(26.4%)患者存在

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