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目的:分析护理结构指标“不同级别护士的配置”对护理结果指标的影响,为中国护理敏感质量指标体系提供基础数据和参考。方法:采取便利抽样法,于2015年在山东省护理质量控制中心的组织下,对山东省121家三级医院(包括10家按三级管理医院)为研究对象进行指标数据采集,以住院患者跌倒发生率、住院患者跌倒伤害率、院内压疮发生率为因变量,以不同级别护士的配置为自变量进行线性回归分析。结果:不同级别护士的配置与3个结果指标之间均存在负相关关系:工作年限≥5年护士占比每增加1%,住院患者跌倒发生率、住院患者跌倒伤害率、院内压疮发生率3个指标分别下降0.130%、0.396%、0.075%;护师及以上护士配置每增加1%,住院患者跌倒伤害率下降0.369%。结论:不同级别护士的配置对护理结果质量有一定的影响,建议各医疗机构可以将不同级别护士的配置作为日常监测指标,用于指导护士人力结构配置,并开展与患者结局和护理质量关联的研究,为管理者提供一种从优化护士人力结构配置角度出发的改善护理质量的参考路径。
OBJECTIVE: To analyze the influence of nursing structure index “different levels of nurse ’s configuration ” on nursing outcome index, and provide the basic data and reference for China’ s nursing sensitive quality index system. Methods: Convenient sampling method was adopted. Under the organization of Shandong Provincial Nursing Quality Control Center in 2015, 121 tertiary hospitals in Shandong Province (including 10 tertiary hospitals) were selected as the research object to collect the index data, and hospitalized patients The incidence of falls, the incidence of falls in hospitalized patients, the incidence of pressure ulcers in hospital were dependent variables, and the linear regression analysis was performed with different levels of nurses as independent variables. Results: There was a negative correlation between the configurations of nurses at different levels and the three outcome indicators: the incidence of falls in hospitalized patients, the incidence of fall injuries in hospitalized patients and the incidence of pressure ulcers in hospital for every 5 years of working years ≥ 5 years The three indicators decreased by 0.130%, 0.396% and 0.075% respectively. For every 1% increase in nurses and nurses, the fall incidence of inpatients decreased by 0.369%. Conclusion: The disposition of nurses in different levels has a certain impact on the quality of nursing results. It is suggested that each medical institution can take the disposition of nurses of different levels as routine monitoring indicators to guide the nurses’ human structure disposition and carry out the correlation with patient outcomes and quality of care Research, to provide a reference for managers to improve the quality of care from the point of view of optimizing the structure of human nurses.