Otwarty dostęp

Patient Outcomes and Hospital Nurses’ Workload: A Cross-Sectional Observational Study in Slovenian Hospitals Using the RN4CAST Survey


Zacytuj

Adjusted and unadjusted odds ratios showing the effects of nurse staffing and nurse education on 30 day in-hospital mortality.

Unadjusted model OR 95% CI p-value Adjusted model OR 95% CI p-value
Model - all together Staffing 1.008 (0.932-1.090) 0.838 1.059 (1.011-1.110) 0.016
Education 1.024 (1.002-1.046) 0.032 1.011 (0.984-1.039) 0.436

Tasks respondents should have performed during their last shift but did not due to lack of time.

Item n % (min - max) Impact of education (p bold - lower presence in group RNs)
Comfort and talk with patients 1000 588/1,009 (58.3) [41.9 - 72.7] 0.060
Educating patients and family 1001 563/1,008 (55.9) [32.3 - 61.9] 0.067
Adequate patient surveillance 1001 362/1,010 (35.8) [22.6 - 47.4] 0.006
Developing or updating nursing care plans or care pathways 1000 362/1,010 (35.8) [22.6 - 53.3] <0.001
Frequent changing of patient position 1001 322/1,010 (31.9) [19.7 - 49.1] 0.043
Oral hygiene 1001 317/1,009 (31.4) [21.1 - 54.4] 0.501
Adequately document nursing care 1001 294/1,010 (29.1) [15.8 - 42.9] 0.006
Planning care 1001 272/1,010 (26.9) [9.7 - 50.0] <0.001
Skin care 1001 275/1,010 (23.2) [7.9 - 40.9] 0.614
Prepare patients and families for discharge 1001 221/1,010 (21.9) [6.45 - 28.6] 0.015
Administer medications on time 1001 175/1,009 (17.3) [3.2 - 28.6] 0.937
Treatments and procedures 1001 138/1,010 (13.7) [6.6 - 21.4] 0.174
Pain management 1001 105/1,010 (10.4) [2.6 - 19.1] 0.088
Composite score Mean=3.9 (SD=0.7)
Min=2.7 - Max=5.1

Patient characteristics (n=36,037) in the included hospitals.

Number
Men 18,768 (52.08)
Emergency admissions 10,682 (29.64)
Inpatient deaths within 30 days of admission 359 (1.00)
Categories
    Injury - S 9,842 (27.31)
    Disease of musculoskeletal system - M 10,680 (29.64)
    Disease of digestive system - K 10,322 (28.64)
    Disease of circulatory system - I 2,841 (7.88)
    Malignant neoplasm - C 2,352 (6.53)
Comorbidities
    Myocardial infarction 437 (1.21)
    Congestive heart failure 978 (2.71)
    Peripheral vascular disease 517 (1.43)
    Cerebrovascular disease 483 (1.34)
    Dementia 387 (1.07)
    Chronic pulmonary disease 667 (1.85)
    Rheumatic disease 151 (0.42)
    Peptic ulcer disease 50 (0.14)
    Mild liver disease 230 (0.64)
    Diabetes without chronic complication 1 866 (5.18)
    Diabetes with chronic complication 199 (0.55)
    Hemiplegia or paraplegia 82 (0.23)
    Renal disease 473 (1.31)
    Malignancy 677 (1.88)
    Moderate or severe liver disease 44 (0.12)
    Metastatic solid tumour 591 (1.64)
    AIDS/HIV 0 (0)

Number of deaths and discharges per hospital, overall (%) of RNs and patient-to-RN ratio.

Hospital Deaths / Discharges (%) RNs(%) Patient-to-RN ratio (M)
AC 26 / 2,440 (1.05) 42.22 15.7179
AH 9 / 1,082 (0.82) 32.25 17.1000
BK 28 / 3,079 (0.90) 29.26 17.5083
BU 40 / 4,076 (0.97) 48.76 14.0615
DQ 13 / 1,817 (0.71) 33.33 15.6152
EA 107 / 10,680 (0.99) 46.18 10.2855
EF 12 / 2,672 (0.45) 29.16 14.3178
FH 5 / 1,844 (0.27) 28.94 19.3851
FZ 102 / 6,193 (1.62) 42.64 17.1487
HG 17 / 1,795 (0.94) 23.68 14.4306
Total 359 / 3,6037 (1.00) 35.65 15.56

Frequency of different tasks during the most recent work shift and differences in educational level.

Items n Never Sometimes Often RN Often HCA Often Education
% % % % % p
Delivering and retrieving food trays 993 17.1 23.1 58.2 32.9 76.7 <0.001
Performing non-nursing care 987 6.1 49.4 44.4 40.5 46.8 0.114
Arranging discharge referrals and transportation (including to long-term care) 992 32.9 30.3 36.8 51 27.4 <0.001
Routine phlebotomy/blood draw for tests 983 48.9 13.4 37.5 76.1 11.1 <0.001
Transporting of patients within hospital 986 22.9 37.1 39.8 32.6 44.7 <0.001
Cleaning patient rooms and equipment 991 16.3 36.3 47.2 28.3 59.9 <0.001
Filling in for non-nursing services not available on off-hours 976 25.5 49.1 25.4 20.3 29 <0.001
Obtaining supplies or equipment 989 12.8 40.8 46.3 49.6 44.1 0.308
Answering phones, clerical duties 998 2.0 15.2 82.6 89 78.4 <0.001
eISSN:
1854-2476
Język:
Angielski
Częstotliwość wydawania:
4 razy w roku
Dziedziny czasopisma:
Medicine, Clinical Medicine, Hygiene and Environmental Medicine