https://scholars.lib.ntu.edu.tw/handle/123456789/112589
標題: | 醫學中心之護理人力與加護病房相關感染和死亡率的病例交叉研究 The Effect of Nurse Staffing on Intensive Care Unit-acquired Infections and Mortality in a Medical Center: A Case-crossover Study |
作者: | 陳幼貴 Chen, Yu-Kuei |
關鍵字: | 加護病房相關感染;護理人力;院內感染;ntensive Care Unit-acquired Infections;nurse staffing;mortality;nosocomial infections | 公開日期: | 2009 | 摘要: | 目的:探討醫學中心內科加護病房護理人力與加護病房相關感染和死亡的關係。究設計:採觀察回溯性法,以病例交叉研究法來分析。究對象:2006~2007年間,台灣北部某醫學中心內科加護病房病患停留天數大於七天且得到加護病房相關感染者。量與結果:研究變項包括24小時護士-病患比率、病患基本資料、入院診斷、合併症、侵入性治療等,有加護病房相關感染430人次,選每人第一次感染做分析,共319人為研究對象,主要的暴露因子24小時護士-病患比率,以平均值為切點,分為暴露及非暴露,以條件式邏輯迴歸統計分析結果,較低的護理人力可減少加護病房感染(OR: 0.687, 0.472-0.999);在癌症病患、使用全靜脈營養注射病患以及血流感染病患中較低的護理人力與減少死亡有相關(p<.05)。論:護理人力是影響加護病房病患的重要因素,有待更詳細的研究來分析其因果。 Objective: To determinate whether low nurse staffing increase intensive care unit-required infections in medical intensive care units.esign: Observational, single center, retrospective study, case-control design to analyze. etting: Medical intensive care unit in a Taiwan university hospital, all patients with ICU-required infections stayed more than 7 days over a 2-yr period.easure and Result: Study variables include daily nurse-to-patient ratio, demographic characteristics, admission diagnosis, comorbidities, daily individual exposure to invasive devices. Of 319 patients, 430 ICU-required infections events. We dichotomized the exposure using mean of 24-hr nurse-to-patient ratio was 1.335 as cutoff. The study showed the lower staffing level was associated with decreased ICU-required infections (OR: 0.687, 0.472-0.999, p=0.049) and decreased mortality in patients who had cancer, total parenteral nutrition or bloodstream infection(p<.05).onclusion: Nurse staffing is main determinant of patient outcomes in ICU. We need further investigation of the impact of nurse staffing in ICU |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/184856 |
顯示於: | 流行病學與預防醫學研究所 |
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ntu-98-R96846002-1.pdf | 23.32 kB | Adobe PDF | 檢視/開啟 |
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