重症医学科护患比与护理质量的相关分析

重症医学科护患比与护理质量的相关分析

杨磊李昂吴志军简伟研么莉

河南宏力医院ICU（杨磊）；国家卫生计生委医院管理研究所护理中心(李昂，么莉) ；中卫护理信息管理研究院（吴志军）；北京大学公共卫生学院（简伟研）

出版日期:2016-07-25 发布日期:2016-07-25

The relationship of nurse staffing level and quality of care

Online:2016-07-25 Published:2016-07-25

摘要/Abstract

摘要： 目的：分析重症医学科（ICU) 护患比与护理质量的相关性，及对患者护理结局的影响。方法：回顾某医院综合ICU 2013-2015 年收治患者数据，统计每月、每季度护患比，选取患者压疮发生率、气管插管非计划性拔管率、护理不良事件总例数、呼吸机相关肺炎（VAP) 发生率等医院感染指标数据。利用线性概率模型进行数据分析。结果：护患比与压疮、气管插管非计划性拔管、VAP、中心导管相关血流感染（CRBSI) 的发生率及护理不良事件的总例数无相关性。护患比与留置尿管相关尿路感染（CAUTI) 发生率呈负相关，护患比每增加1 个单位，尿路感染的可能性将降低0.7%。结论：护患比对护理质量有一定的影响，多中心研究是下一步研究方向，护患比及护理质量相关敏感指标应进行常态化监测。

Abstract: Objective: To examine the relationships between nurse staffing levelwith quality of care and patients'outcomein intensive care unit (ICU). Methods: For this retrospective study, discharge data from 2013 to 2015 was obtained from a general ICU. Outcome measures include pressure ulcer prevalence rates, unplanned extubation, nursing adverse events, and ventilator-associatedpneumonia (VAP). The nurse staffing level was assessed by the number of patients assigned to a nurse. Linear probability model was used to assess the effects of nurse staffing on quality of care.Results:There were no statistical significances between nursing staffing level and pressure ulcers, unplanned extubation, VAP, central catheter related bloodstream infection (CRBSI) and nursing adverse events. A lower number of patients per nurse was significantly associated with a lower incidence of urinary tract infection.Conclusion: This study found that nurse staffing influence quality of nursing. The findings suggest that hospitals could promote nursing quality by improving nurse staffing.

杨磊李昂吴志军简伟研么莉. 重症医学科护患比与护理质量的相关分析[J]. , 2016, 16(7): 891-894.