篇名 | 台灣急性醫院病房護理人力配置對住院病人死亡率影響之縱貫研究 |
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卷期 | 20:1 |
並列篇名 | Effects of Nurse Staffing Ratios on Patient Mortality in Taiwan Acute Care Hospitals: A Longitudinal Study |
作者 | 梁亞文 、 蔡淑鳳 、 陳文意 |
頁次 | 001-008 |
關鍵字 | 護理人力配置 、 病人死亡率 、 廣義估計方程式 、 nurse staffing ratio 、 patient mortality 、 generalized estimating equation 、 MEDLINE 、 Scopus 、 SSCI 、 TSCI 、 TSSCI 、 SCIE |
出刊日期 | 201203 |
Background: The nurse workload in Taiwan averages two to seven times more than that in the United States and other developed countries. Previous studies have indicated heavy nursing workload as an underlying cause of preventable patient death. No studies have yet explored the relationship between nurse staffing ratio and patient mortality in Taiwan.
Purpose: This study explored the effect of nurse staffing ratios on patient mortality in acute care hospitals in Taiwan and considered the implications in terms of policy.
Methods: Using stratified random sampling, 108 hospital nursing units in 32 of Taiwan’s 441 accredited Western medicine district/regional hospitals and medical centers were included in the study. Variables were retrospectively measured from 108 wards by using monthly data during a 7-month period. A generalized estimating equation logistic model was used to obtain more precise estimates of the nurse staffing effect by controlling for hospital characteristic and patient acuity variables.
Results: The population-averaged odds ratio for the incidence of death between the low and high patientYnurse ratio groups was 3.617 (95% CI = [1.930, 6.776]). The risk of death in the high patientYnurse ratio group was significantly higher than in the low patientYnurse ratio group.
Conclusions: Nurse staffing levels affect patient outcomes. Faced with the problem of inadequate nurses for hospital healthcare needs, Taiwanese policymakers should work to implement a legislatively mandated minimum patientYnurse ratio on a shiftby- shift basis to regulate nurse staffing. In setting guidelines for nurse staffing, policymakers must consider nursing staff characteristics in addition to the number of nurses.