Nurse Staffing and Adverse Events on Inpatient Units

住院病房的护士人员配置和不良事件

基本信息

批准号：
6984693
负责人：
EILEEN T LAKE
金额：
$ 36.12万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-08-01 至 2008-01-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/6984693
关键词：
accidental falls behavioral /social science research tag clinical research decubitus ulcer health care model health services research tag hospital organization /administration hospitals human data nurse performance nursing administration nursing care evaluation nursing care quality nursing personnel nursing process nursing research nursing skill /technique patient safety /medical error

项目摘要

DESCRIPTION (provided by applicant): Patient falls and pressure ulcers are designated as "nursing-sensitive quality indicators" by national groups such as the American Nurses Association and the National Quality Forum. Yet research linking the occurrence of falls and pressure ulcers to differences in nurse staffing has yielded equivocal findings. Unreliable measurement of adverse events and inadequate measures of nurse staffing could account for the inconclusive findings. Prior studies have analyzed these effects at hospital and nursing unit levels, but never simultaneously. Differences in the nursing practice environment may moderate the link between staffing and adverse events, although this has not been tested. The proposed study builds on evidence developed by this research team that nurse staffing and the practice environment influence patient outcomes. This study advances our understanding of the relationship between staffing and patient adverse events by 1) calculating adverse events using secondary data from observational prevalence studies and incident reports, 2) using a comprehensive set of nurse staffing measures that account for qualitative as well as quantitative differences among RNs, 3) examining these relationships at both the nursing unit and hospital levels, and 4) exploring the influence of a formally-recognized favorable nursing practice environment on these relationships. Multi-level models will be used to predict the effects of staffing on rate of falls at the nursing unit level and pressure ulcers at both the patient and the nursing unit levels using data from 4,300 nursing units in 650 community hospitals in the ANA-sponsored National Database of Nursing Quality Indicators. American Nurses Credentialing Center Magnet Designation status will be used to differentiate the nursing practice environment across hospitals and explored as a hospital-level factor moderating the associations between staffing and outcomes. This study will strengthen the evidence base on how nurse staffing patterns and practice environments support the quality and safety of patient care.

描述（由申请人提供）：美国护士协会和国家质量论坛等国家团体将患者跌倒和压力溃疡指定为“对护理敏感质量指标”。然而，将跌倒和压力溃疡的发生与护士人员配备差异联系起来的研究产生了模棱两可的发现。对不良事件的不可靠度量和护士人员配备的措施不足可能解释了不确定的发现。先前的研究已经在医院和护理单位水平分析了这些影响，但从未同时进行。护理实践环境中的差异可能会缓解人员和不良事件之间的联系，尽管尚未进行测试。拟议的研究基于该研究团队的发展证据，该研究团队护士人员配备和实践环境会影响患者的结果。这项研究通过1）通过观察性普遍研究和事件报告中的二级数据来计算不良事件之间对人员之间的关系的理解，2）使用一组全面的护士人员配备措施，这些措施涉及定性以及RN之间的定量差异，3）在护理单位和医院级别上进行了良好的练习，并探讨了对这些关系的练习，以及4）对这些相互作用的练习，并构成了一个形式上的影响。多级模型将用于预测人员配备对护理单位水平下跌倒率的影响，并使用来自ANA赞助的国家护理质量指标的650个社区医院的4,300个护理单位中的4,300个护理单位的数据进行压力溃疡。美国护士认证中心磁铁指定状态将用于区分医院的护理实践环境，并作为医院级别的因素进行探索，以调节人员和成果之间的关联。这项研究将加强有关护士人员配备模式和练习环境如何支持患者护理的质量和安全的证据。