期刊
JOURNAL OF CLINICAL NURSING
卷 31, 期 17-18, 页码 2562-2573出版社
WILEY
DOI: 10.1111/jocn.16075
关键词
cancer surgeries; failure to rescue; in-hospital mortality; nurse staffing; postoperative complications
类别
资金
- Ministry of Health, Labour and Welfare, Japan [19AA2007, 20AA2005]
- Ministry of Education, Culture, Sports, Science and Technology, Japan [20H03907]
The study found that additional registered nurses were associated with decreased postoperative complications. However, the incremental benefit of additional registered nurses may disappear if hospitals allocate five to six registered nurses per general ward patients.
Aims and Objectives To examine the non-linear dose-response associations between nurse staffing levels and patient outcomes using a nationwide inpatient database in Japan. Background Previous studies showed that higher nurse staffing levels were associated with better patient outcomes. However, it remains unclear whether there are thresholds for the associations between higher nurse staffing levels and improved patient outcomes. Designs Retrospective observational study design following the STROBE guideline. Methods We identified all patients aged >= 20 years who underwent one of six major cancer surgeries between July 2010 and March 2018 using data from the Diagnosis Procedure Combination database, a nationwide database for acute-care inpatients in Japan. Restricted cubic spline regression analyses, the statistical method that allows non-linear functional form, were performed with several scenarios of cut-off points to examine the dose-response associations between patient-to-nurse ratio per shift and failure to rescue, 30-day in-hospital mortality and postoperative complications. Results Among 645,687 patients, restricted cubic spline regression analyses showed insignificant associations of patient-to-nurse ratio with failure to rescue and 30-day in-hospital mortality with no threshold, but a reverse J-shaped association with postoperative complications with a threshold of patient-to-nurse ratio per shift of 5.4. Conclusions In terms of postoperative complications, additional registered nurses were associated with decreased postoperative complications. However, this incremental benefit of additional registered nurses may disappear if hospitals allocate five to six number of registered nurses in general wards. Relevance to Clinical Practice This study suggested that additional registered nurses over one per five to six patients may not bring the incremental benefit to decrease postoperative complications.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据