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Effects of Hospital Nurse Staffing on in-hospital Mortality, Pneumonia, Sepsis, and Urinary Tract Infection in Surgical Patients

의료기관 간호사 확보수준이 수술환자의 사망, 폐렴, 패혈증, 요로감염에 미치는 영향

  • Kim, Yunmi (Department of Nursing, Eulji University) ;
  • Cho, Sung-Hyun (College of Nursing, The Research Institute of Nursing Science, Seoul National University) ;
  • June, Kyung Ja (Department of Nursing, Soonchunhyang University) ;
  • Shin, Soon Ae (Department of Health Promotion & Management, National Health Insurance Corporation) ;
  • Kim, Jiyun (Department of Nursing, Gachon University)
  • 김윤미 (을지대학교 간호학과) ;
  • 조성현 (서울대학교 간호대학.간호과학연구소) ;
  • 전경자 (순천향대학교 간호학과) ;
  • 신순애 (국민건강보험공단) ;
  • 김지윤 (가천대학교 간호학과)
  • Received : 2012.02.06
  • Accepted : 2012.09.25
  • Published : 2012.10.31

Abstract

Purpose: This study was done to examine relationships between nurse staffing level and postsurgical patient outcomes using inpatient database from the National Health Insurance. Methods: Records of 111,491 patients who received one of 12 types of surgery between January and December, 2009 were identified and analyzed in this study. Nurse staffing level was measured using adjusted nurse staffing grades from 0 to 7. Patient outcomes were defined as in-hospital mortality, or pneumonia, sepsis, or urinary tract infection after surgery. Logistic regression analyses estimated by Generalized Estimation Model, were used to analyze the association between nurse staffing level and patient outcomes. Results: An inverse relationship was found between nurse staffing and patient mortality. Compared with patients who were cared for in hospitals with the highest nurse staffing (Grades 0-1), increases in the odds of dying were found in those with Grades 6-7 [OR (odds ratio)=2.99, 95% CI (confidence interval)=1.94-4.60], those with Grades 4-5 (OR=1.78, 95% CI=1.24-2.57) and those with Grades 2-3 (OR=1.57, 95% CI=1.25-1.98). Lower nurse staffing level was also associated with higher number of cases in pneumonia and sepsis. Conclusion: Policies for providing adequate nurse staffing is required to enhance quality of care and lead to better perioperative patient outcomes.

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