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Nurse staffing and patient outcomes in Belgian acute hospitals: cross-sectional analysis of administrative data.

机译:比利时急诊医院的护士人员配备和患者预后:行政数据的横断面分析。

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BACKGROUND: Studies have linked nurse staffing levels (number and skill mix) to several nurse-sensitive patient outcomes. However, evidence from European countries has been limited. OBJECTIVES: This study examines the association between nurse staffing levels (i.e. acuity-adjusted Nursing Hours per Patient Day, the proportion of registered nurses with a Bachelor's degree) and 10 different patient outcomes potentially sensitive to nursing care. DESIGN-SETTING-PARTICIPANTS: Cross-sectional analyses of linked data from the Belgian Nursing Minimum Dataset (general acute care and intensive care nursing units: n=1403) and Belgian Hospital Discharge Dataset (general, orthopedic and vascular surgery patients: n=260,923) of the year 2003 from all acute hospitals (n=115). METHODS: Logistic regression analyses, estimated by using a Generalized Estimation Equation Model, were used to study the association between nurse staffing and patient outcomes. RESULTS: The mean acuity-adjusted Nursing Hours per Patient Day in Belgian hospitals was 2.62 (S.D.=0.29). The variability in patient outcome rates between hospitals is considerable. The inter-quartile ranges for the 10 patient outcomes go from 0.35 for Deep Venous Thrombosis to 3.77 for failure-to-rescue. No significant association was found between the acuity-adjusted Nursing Hours per Patient Day, proportion of registered nurses with a Bachelor's degree and the selected patient outcomes. CONCLUSION: The absence of associations between hospital-level nurse staffing measures and patient outcomes should not be inferred as implying that nurse staffing does not have an impact on patient outcomes in Belgian hospitals. To better understand the dynamics of the nurse staffing and patient outcomes relationship in acute hospitals, further analyses (i.e. nursing unit level analyses) of these and other outcomes are recommended, in addition to inclusion of other study variables, including data about nursing practice environments in hospitals.
机译:背景:研究已将护士的人员配备水平(人数和技能组合)与几个护士敏感的患者结局相关联。但是,来自欧洲国家的证据有限。目的:本研究调查了护士人员配置水平(即按患者天数进行视力调整的护理时间,具有学士学位的注册护士比例)与10种可能对护理敏感的患者结局之间的关系。设计设置对象:来自比利时护理最低数据集(一般急性护理和重症监护病房:n = 1403)和比利时医院出院数据集(一般,骨科和血管外科患者:n = 260,923)的链接数据的横断面分析(2003年)从所有急诊医院(n = 115)中获得。方法:采用广义估计方程模型进行的逻辑回归分析用于研究护士人员编制与患者预后之间的关系。结果:比利时医院每位患者每天调整的视力平均护理小时数为2.62(S.D. = 0.29)。医院之间患者预后率的差异很大。 10例患者结果的四分位数范围从深静脉血栓形成的0.35变为无法挽救的3.77。在每位患者每天进行视力调整的护理时间,具有学士学位的注册护士比例与所选患者的结局之间没有发现显着相关性。结论:不应推断医院一级的护士配备措施与患者结局之间没有关联,因为这暗示着比利时人员医院的护士配备不会对患者结局产生影响。为了更好地了解急诊医院中护士人员配备和患者结局关系的动态,除了纳入其他研究变量(包括有关护理实践环境的数据)外,还建议对这些结果和其他结局进行进一步分析(即,护理部门水平分析)。医院。

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