Nursing Outlook最新文献_第8页

Self-management behaviors for the care transition of cardiac patients: A scoping review 心脏病人护理转变的自我管理行为：范围综述。

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-11-01 DOI: 10.1016/j.outlook.2025.102581

João Cruz Neto, Andrezza Rayana Da Costa Alves Delmiro, Lorena Pinheiro Barbosa, Priscila de Souza Aquino, Viviane Martins da Silva, Marcos Venícios de Oliveira Lopes

Background

Studies have increasingly focused on the transition of care in heart disease. Self-management behaviors during these transitions are essential for ensuring effective care, reducing hospitalizations, and improving quality of life.

Purpose

Identify self-management behaviors in patients with cardiac diseases during care transitions.

Methods

A scoping review was conducted following the JBI methodology and guided by the PRISMA-ScR. Searches were performed in six databases (MEDLINE, Web of Science, CINAHL, Scopus, Embase, and LILACS) between January and February 2025. Inclusion criteria comprised studies addressing health self-management behaviors in patients of any age group with cardiac disease during a care transition process. Data synthesis followed Whittemore & Knafl’s approach, and findings were analyzed using Meleis’ Transitions Theory and presented in tables and diagrams.

Findings

Seventeen studies met the inclusion criteria, predominantly from the United States and with cross-sectional designs. Fourteen positive behaviors (e.g., medication adherence, risk recognition, communication with providers, and lifestyle adjustments) and 21 negative behaviors (e.g., treatment interruption, lack of understanding of the medication regimen, limited follow-up, and addictive behaviors) were identified. These behaviors were mapped to the outcomes of restoration, maintenance, protection, and promotion as defined by the Transitions Theory.

Discussion

The review underscores the centrality of medication management and education in the care transition for cardiac patients. Self-management behaviors are influenced by personal, social, and systemic factors, highlighting the need for structured nursing interventions, such as patient education, follow-up, and coordination across care settings, to strengthen continuity of care and prevent readmissions. It was noted that the topic of care transition is still underexplored in the literature, which limits the generalization of the data to all contexts of transition in cardiac disease.

Reporting Method

PRISMA.

背景：研究越来越关注心脏病护理的转变。这些过渡期间的自我管理行为对于确保有效护理、减少住院和提高生活质量至关重要。目的：了解心脏病患者在护理过渡期的自我管理行为。方法：在PRISMA-ScR的指导下，按照JBI方法学进行范围审查。检索于2025年1月至2月在六个数据库（MEDLINE、Web of Science、CINAHL、Scopus、Embase和LILACS）中进行。纳入标准包括在护理过渡过程中处理任何年龄组心脏病患者健康自我管理行为的研究。数据合成遵循Whittemore & Knafl的方法，并使用Meleis的过渡理论分析结果，并以表格和图表的形式呈现。结果：17项研究符合纳入标准，主要来自美国，采用横断面设计。14种积极行为（如服药依从性、风险认知、与提供者沟通和生活方式调整）和21种消极行为（如治疗中断、缺乏对药物治疗方案的理解、有限的随访和成瘾行为）被确定。这些行为映射到由过渡理论定义的恢复、维护、保护和促进的结果。讨论：该综述强调了药物管理和教育在心脏病患者护理转变中的中心地位。自我管理行为受到个人、社会和系统因素的影响，强调需要有组织的护理干预措施，如患者教育、随访和跨护理环境的协调，以加强护理的连续性和防止再入院。值得注意的是，在文献中，护理转变的主题仍未得到充分探讨，这限制了将数据推广到心脏病转移的所有背景。报告方式：PRISMA。

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引用次数: 0

A cross-country comparison of nursing research outputs in relation to funding: An artificial intelligence-enhanced multivariate analysis 护理研究成果与资助的跨国比较：人工智能增强的多变量分析

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-11-01 DOI: 10.1016/j.outlook.2025.102583

Elena Sblendorio PhD, RN , Marco Tomietto PhD, MSN, RN , Vincenzo Dentamaro PhD , Alessio Lo Cascio PhD, RN , Guglielmo Imbriaco , Michela Piredda PhD, MSc, RN , Giancarlo Cicolini PhD, MSN, RN

Background

Global nursing research investments aim to improve health outcomes, yet the funding-quality relationship remains poorly understood.

Purpose

To analyze international nursing research trends (2017-2022) across the 29 most productive countries, examining correlations between declared funding and publication quantity and quality.

Methods

AI-enhanced scientometric analysis employed a Python algorithm matching extracted journals for each country's publication to corresponding quartiles (Q1-Q4), using Scimago's 2022 Scopus update. Two quality metrics -the ratio of total citations to total publications (TC/TP) and the proportion of Q1 publications to total publications (Q1/TP)- were correlated. Local Outlier Factor technique enabled outlier detection.

Findings

Nursing research demonstrated quadratic growth. The two quality metrics strongly correlated (r = 0.916, p< 0.001). The number of publications declaring funding correlated highly with publication quantity (r = 0.955, p < 0.001), but not with quality (r = -0.077, p = 0.686). The USA led in publication volume, while the UK, and several European nations led in quality. Notable growth occurred in Indonesia, Saudi Arabia, China, Iran, South Korea, and Turkey.

Discussion

Findings suggest that while funding drives publication quantity, quality enhancement requires comprehensive investment strategies, including indirect expenses for institutional research infrastructure and capacity building.

全球护理研究投资旨在改善健康结果，但对资金与质量的关系仍知之甚少。目的分析国际护理研究趋势（2017-2022年）在29个生产力最高的国家，检查申报资金与出版物数量和质量之间的相关性。方法采用Python算法，使用Scimago的2022年Scopus更新，将每个国家的出版物提取的期刊与相应的四分位数（Q1-Q4）进行匹配。两个质量指标——总引用数与总发表数之比（TC/TP）和Q1发表数与总发表数之比（Q1/TP）——是相关的。局部离群因子技术实现了离群检测。护理研究显示出二次增长。这两个质量指标有很强的相关性（r = 0.916, p<； 0.001）。宣布资助的出版物数量与发表数量高度相关（r = 0.955, p <； 0.001），但与质量不相关（r = -0.077, p = 0.686）。美国在出版物数量上领先，而英国和几个欧洲国家在质量上领先。印度尼西亚、沙特阿拉伯、中国、伊朗、韩国和土耳其的增长显著。讨论结果表明，虽然资助推动了发表数量，但提高质量需要全面的投资策略，包括机构研究基础设施和能力建设的间接支出。

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引用次数: 0

Predictors of registered nurse employment and earnings in long-term care 长期护理中注册护士就业和收入的预测因素。

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-11-01 DOI: 10.1016/j.outlook.2025.102586

Joanne Spetz PhD, FAAN , Timothy Bates MPP , Laura Wagner PhD, RN, FAAN

Background

Nearly 10% of registered nurses (RNs) work in long-term care (LTC). Previous research has reported that RNs working in LTC receive lower pay than those in hospitals.

Purpose

This study examined demographic and human capital characteristics associated with RN employment in LTC and wages.

Methods

National survey data were analyzed using descriptive and regression analyses.

Discussion

RNs working in LTC are older, more often educated outside the United States, and more likely to live in rural areas than other RNs. LTC-employed RNs earn 9.5% less than non-LTC RNs. There were no racial, ethnic, or sex differences in the probability of employment in LTC or in the wages earned by LTC or non-LTC nurses.

Conclusion

Our results point to the importance of addressing low wages for RNs who work in LTC settings. LTC employers should also seek to improve other work environment attributes to make LTC employment more attractive to RNs.

背景：近10%的注册护士从事长期护理（LTC）工作。以前的研究报告说，在LTC工作的注册护士的工资低于在医院工作的注册护士。目的：本研究考察了与LTC中护士就业和工资相关的人口统计学和人力资本特征。方法：对全国调查资料进行描述性分析和回归分析。讨论：与其他注册护士相比，在LTC工作的注册护士年龄更大，在美国以外接受教育的情况更多，而且更有可能生活在农村地区。ltc注册护士的收入比非ltc注册护士低9.5%。在长期护理中心就业的可能性以及长期护理中心和非长期护理中心护士的工资方面，没有种族、民族或性别差异。结论：我们的研究结果指出了解决在LTC环境中工作的注册护士低工资问题的重要性。LTC雇主还应寻求改善其他工作环境属性，以使LTC就业对注册护士更具吸引力。

引用次数: 0

Rethinking global nursing leadership: The Strategic Leadership Framework 重新思考全球护理领导：战略领导框架。

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-11-01 DOI: 10.1016/j.outlook.2025.102549

Catherine L. Gilliss PhD, FAAN , Paula Milone-Nuzzo PhD, RN, FHHC, FAAN

Background

Nursing leadership is often viewed as the exclusive responsibility assigned to formal leadership roles. Our work suggests that important changes are being led by nurses, regardless of their assigned roles.

Purpose

By presenting a framework of leadership, we illustrate how nurses lead meaningful change.

Methods

Case studies from nurses in leadership roles from around the globe provided affirming examples of the relevance of the Strategic Leadership Framework. Case studies were analyzed to identify key concepts for leading change beyond traditional settings.

Discussion

The key leadership activities of understanding culture and context, effective communication and collaboration provide the foundation for the Strategic Leadership Framework.

Conclusions

These cases provide beginning confirmatory evidence of the relevance of the framework and illustrate the ways in which nurses without formal leadership titles lead outside of the organizational settings. Specifically, the framework points to the importance of considering context, leveraging collaboration and communication, and using strategic leadership interventions to bring about meaningful change.

背景：护理领导通常被视为分配给正式领导角色的专属责任。我们的工作表明，重要的变化是由护士领导的，不管他们被分配的角色是什么。目的：通过提出一个领导框架，我们说明护士如何领导有意义的变革。方法：来自全球各地的护士领导角色的案例研究提供了战略领导框架相关性的肯定例子。对案例研究进行了分析，以确定超越传统环境的领导变革的关键概念。讨论：理解文化和环境、有效沟通和协作的关键领导活动为战略领导框架提供了基础。结论：这些案例为该框架的相关性提供了初步的证实性证据，并说明了没有正式领导头衔的护士在组织环境之外的领导方式。具体来说，该框架指出了考虑环境、利用协作和沟通以及使用战略领导干预来带来有意义的变革的重要性。

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引用次数: 0

Advanced practice nursing in the European Union: A scoping review 欧盟高级护理实践：范围审查

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-11-01 DOI: 10.1016/j.outlook.2025.102588

Morin Galfout Sara APN , Schwingrouber Jocelyn RN, PhD , Colson Sébastien RN, PhD

Background

Advanced nursing practice is expanding across the European Union. Although the International Council of Nurses provides a unified definition, implementation varies widely among member states.

Purpose

To assess advanced practice in the EU and identify similarities and differences in regulation and practice.

Methods

This scoping review followed Joanna Briggs Institute and PRISMA guidelines.

Findings

Of 2,205 studies screened, 184 met eligibility criteria. Advanced nursing practice shows consistent patterns in education, competencies, and practice models but remains fragmented in title recognition, regulation, and specialty development. In some countries, formal structures are still absent.

Discussion

The European Union faces shared public health challenges, particularly long-term care needs. Advanced nursing practice has proven effective in several countries, and European-level recognition could foster broader integration. This review highlights commonalities and national variations, offering comparative insights to guide international policies that strengthen the legitimacy and visibility of advanced practice nurses.

高级护理实践正在整个欧盟扩展。尽管国际护士理事会提供了一个统一的定义，但各成员国的实施情况却大相径庭。目的评估欧盟的先进实践，识别监管和实践的异同。方法本综述遵循乔安娜布里格斯研究所和PRISMA指南。在2205项研究中，184项符合入选标准。高级护理实践在教育、能力和实践模式方面表现出一致的模式，但在职称认定、监管和专业发展方面仍然分散。在一些国家，仍然没有正式的结构。欧盟面临着共同的公共卫生挑战，特别是长期护理需求。先进的护理实践在一些国家被证明是有效的，欧洲层面的认可可以促进更广泛的融合。本综述强调了共性和国家差异，为指导加强高级执业护士合法性和可见度的国际政策提供了比较见解。

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引用次数: 0

A nurse-led clinical practice model to increase healthcare reach among underserved families during public health emergencies: A randomized controlled trial 在突发公共卫生事件中，以护士为主导的临床实践模式增加服务不足家庭的医疗服务范围：一项随机对照试验

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-11-01 DOI: 10.1016/j.outlook.2025.102591

Vincent Guilamo-Ramos PhD, RN, MPH, LCSW, ANP-BC, PMHNP-BC, FAAN , Adam Benzekri MPH, MS , Desiree Williams MPH , Marco Thimm-Kaiser MPH , Marina Mautner Wizentier MS , Melody Goodman PhD , Brenda Amezquita-Castro MPP, MA , Holly Hagan PhD

Background

Latino and Black families experience inequities in healthcare delivery, particularly during public health emergencies.

Purpose

To evaluate whether a nurse-led, household-based clinical practice model, the Nurse-Community-Family Partnership (NCFP) increased COVID-19 testing in an underserved, minoritized community as proof-of-concept for enhancing health service reach.

Methods

In a parallel, assessor-blinded group RCT (August 2021–March 2023), 146 households (392 individuals; mean [SD] age 37.9 [20.0]; 257 [65.6%] female; 279 [71.2%] Latino; 94 [24.0%] Black) were randomized 2:1 to NCFP or standard of care and followed for 9 months. Analyses used multilevel and longitudinal logistic regression.

Discussion

At 9 months, experimental participants (n = 256) had 2.69 times the odds (95 % CI 1.06-6.78) of any COVID-19 testing during the study and 3.16 times the odds of past-month testing (95 % CI 1.96-5.08), compared with controls (n = 136)..

Conclusion

NCFP, a nurse-led, household-based clinical practice model, enhanced health service reach during a public health emergency.

Trial Protocol and Statistical Analysis Plan

ClinicalTrials.gov: https://clinicaltrials.gov/study/NCT04832919

拉丁裔和黑人家庭在医疗保健服务方面面临不公平待遇，特别是在突发公共卫生事件期间。为了评估护士主导的、以家庭为基础的临床实践模式，护士-社区-家庭伙伴关系（NCFP）在服务不足的少数族裔社区增加了COVID-19检测，作为扩大卫生服务覆盖面的概念验证。方法在一项平行评估盲组RCT（2021年8月- 2023年3月）中，146户家庭（392人，平均[SD]年龄37.9[20.0],257[65.6%]女性，279[71.2%]拉丁裔，94[24.0%]黑人）随机分为2:1组，接受NCFP或标准护理，随访9个月。分析采用多水平和纵向逻辑回归。在9个月时，与对照组（n = 136）相比，实验参与者（n = 256）在研究期间进行任何COVID-19检测的几率（95 % CI 1.06-6.78）为2.69倍，过去一个月检测的几率（95 % CI 1.96-5.08）为3.16倍。结论ncfp是一种以护士为主导、以家庭为基础的临床实践模式，在突发公共卫生事件中提高了卫生服务的覆盖面。试验方案和统计分析计划clinicaltrials.gov: https://clinicaltrials.gov/study/NCT04832919

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引用次数: 0

Consensus-based indicators of advanced practice nursing outcomes: Results of a Delphi study in France 基于共识的高级实践护理结果指标：法国德尔菲研究的结果。

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-11-01 DOI: 10.1016/j.outlook.2025.102580

Jean Toniolo , Elom Iroukora , Yann Colven , Faustine Abla Dessi , Camille Vieu , Magdeleine Duvernoy , Karen Bertet , Rebecca Rioche , Aurélie Charrié Lagarde , Camille Lebrun , Estelle Barbe , Nolga Boussely , Christelle Roux , Julien Valeille , Agnès Lohues , Marion Bigas , Amélie Beloni , Clémence Thébaut , Jérome Wittwer , Valérie Berger , Pascale Beloni

Background

Despite one of the world’s most advanced health systems, advanced practice nursing (APN) roles in France are less than a decade old. Globally, APNs strengthen access, quality, and efficiency of care, but sustaining these roles requires demonstrating outcomes meaningful to patients, providers, and policymakers.

Purpose

To describe consensus among French stakeholders on patient- and system-level indicators for evaluating APN contributions.

Methods

A two-round Delphi process, followed by a nominal group discussion, was conducted. Participants included APNs, nurse managers, physicians, and academics. Candidate indicators, classified using Hamric’s framework, were rated on nine-point Likert scales; indicators with ≥75% agreement were validated.

Findings

Forty indicators were retained across seven domains, reflecting outcomes such as patient access, continuity, quality of care, collaboration, and leadership.

Discussion

Consensus indicators show how APN practice is viewed in France—focused on expertise, coordination, and integration. This aligns with global APN competencies but contrasts with physician-substitution models elsewhere.

Conclusion

These validated indicators provide a foundational framework for evaluating APN contributions in France. They offer a strategic tool to support integration, and to inform policy.

背景：尽管是世界上最先进的卫生系统之一，高级实践护理（APN）的角色在法国不到十年的历史。在全球范围内，apn加强了护理的可及性、质量和效率，但要维持这些作用，就需要展示对患者、提供者和政策制定者有意义的结果。目的：描述法国利益相关者对评估APN贡献的患者和系统级指标的共识。方法：进行了两轮德尔菲过程，然后进行了名义上的小组讨论。参与者包括apn、护士经理、医生和学者。候选指标使用哈姆里克的框架进行分类，按照李克特九分制进行评分；对一致性≥75%的指标进行验证。研究结果：在7个领域保留了40个指标，反映了患者可及性、连续性、护理质量、协作和领导力等结果。讨论：共识指标显示了法国如何看待APN实践——重点是专业知识、协调和整合。这与全球APN能力一致，但与其他地方的医生替代模式形成对比。结论：这些经过验证的指标为评估法国APN的贡献提供了基础框架。它们提供了一种战略工具来支持整合，并为政策提供信息。

{"title":"Consensus-based indicators of advanced practice nursing outcomes: Results of a Delphi study in France","authors":"Jean Toniolo , Elom Iroukora , Yann Colven , Faustine Abla Dessi , Camille Vieu , Magdeleine Duvernoy , Karen Bertet , Rebecca Rioche , Aurélie Charrié Lagarde , Camille Lebrun , Estelle Barbe , Nolga Boussely , Christelle Roux , Julien Valeille , Agnès Lohues , Marion Bigas , Amélie Beloni , Clémence Thébaut , Jérome Wittwer , Valérie Berger , Pascale Beloni","doi":"10.1016/j.outlook.2025.102580","DOIUrl":"10.1016/j.outlook.2025.102580","url":null,"abstract":"<div><h3>Background</h3><div>Despite one of the world’s most advanced health systems, advanced practice nursing (APN) roles in France are less than a decade old. Globally, APNs strengthen access, quality, and efficiency of care, but sustaining these roles requires demonstrating outcomes meaningful to patients, providers, and policymakers.</div></div><div><h3>Purpose</h3><div>To describe consensus among French stakeholders on patient- and system-level indicators for evaluating APN contributions.</div></div><div><h3>Methods</h3><div>A two-round Delphi process, followed by a nominal group discussion, was conducted. Participants included APNs, nurse managers, physicians, and academics. Candidate indicators, classified using Hamric’s framework, were rated on nine-point Likert scales; indicators with ≥75% agreement were validated.</div></div><div><h3>Findings</h3><div>Forty indicators were retained across seven domains, reflecting outcomes such as patient access, continuity, quality of care, collaboration, and leadership.</div></div><div><h3>Discussion</h3><div>Consensus indicators show how APN practice is viewed in France—focused on expertise, coordination, and integration. This aligns with global APN competencies but contrasts with physician-substitution models elsewhere.</div></div><div><h3>Conclusion</h3><div>These validated indicators provide a foundational framework for evaluating APN contributions in France. They offer a strategic tool to support integration, and to inform policy.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"73 6","pages":"Article 102580"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Developing an artificial intelligence-based clinical decision support system for nursing diagnoses 开发基于人工智能的护理诊断临床决策支持系统

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-11-01 DOI: 10.1016/j.outlook.2025.102585

Gülengün Türk PhD , Nihal Taşkıran PhD , Orhan Er PhD , Emre Ölmez PhD , Fürüzan Bozkurt Kozan PhD

Background

Nursing diagnoses are crucial for care planning and communication, yet achieving diagnostic accuracy is often challenging due to workload and complex patient data. Integrating artificial intelligence (AI) into clinical practice may enhance clinical reasoning and promote a standardized nursing language.

Aim

This methodological study aimed to develop an AI-based clinical decision support system that ensures diagnostic accuracy with fewer defining characteristics.

Methods

Based on Gordon’s Functional Health Patterns Model, data were collected from 122 patients, including 117 defining characteristics, 59 risk factors, and 19 nursing diagnoses. Machine learning algorithms were tested for accuracy.

Results

The Naive Bayes algorithm achieved 96.33% accuracy using all indicators, while Gradient Boosting reached 82.94% with the 50 most important variables. Both effectively identified key diagnoses such as “Obesity” and “Acute Pain.”

Conclusion

The developed AI-based decision support system demonstrated high accuracy and potential to assist nurses in making faster and more consistent diagnostic decisions.

护理诊断对于护理计划和沟通至关重要，但由于工作量和复杂的患者数据，实现诊断准确性通常具有挑战性。将人工智能（AI）融入临床实践可以提高临床推理能力，促进规范化护理语言。目的：本方法学研究旨在开发一种基于人工智能的临床决策支持系统，以较少的定义特征确保诊断准确性。方法基于Gordon功能健康模式模型，收集122例患者的数据，包括117个定义特征、59个危险因素和19个护理诊断。测试了机器学习算法的准确性。结果朴素贝叶斯算法对所有指标的准确率达到96.33%，梯度增强算法对50个最重要变量的准确率达到82.94%。两者都能有效地识别出“肥胖”和“急性疼痛”等关键诊断。结论所开发的基于人工智能的决策支持系统具有较高的准确性和潜力，可以帮助护士做出更快、更一致的诊断决策。

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引用次数: 0

Were hospital financial resources associated with nurse staffing levels before and during COVID-19? 医院的财务资源是否与COVID-19之前和期间的护士人员配备水平相关？

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-11-01 DOI: 10.1016/j.outlook.2025.102573

Nicholas Chong , Patricia Pittman PhD , Michael Herron , Qian “Eric” Luo , Hong-Lun Tiunn , Jamar Slocum , Kenneth Rempher , John Martin

Background

Policymaker tend to assume that the problem of low nurse staffing is a result of hospitals financial contraints.

Purpose

This study explores whether higher hospital resource levels were associated with higher nurse staffing before (2019) and then during (2020–2022) the COVID-19 pandemic, a period of increased funding to most U.S. hospitals.

Methods

We used Premier Inc.’s OperationsAdvisor database and the PINC AI Healthcare Database to explore this question in a sample of 78 hospitals. We measured resources using both (a) current ratio (assets to liabilities) and (b) days cash on hand, and our main outcome measure was nurse hours per patient day (NHPPD), including agency and overtime nurse hours. We employed a multivariate random-effects model with time interactions with the financial variables.

Findings

We found that in the pre-COVID period, there was no association between hospital financial resources and nurse staffing. During the first two periods of the pandemic, despite the overall staffing increase in the first wave, we observed an inverse association between hospitals’ current ratio and NHPPD.

Conclusion

Thus, even with the surge in government subsidies during the pandemic, greater resources were not associated with higher nurse staffing.

背景：政策制定者倾向于认为护士编制不足的问题是医院财政紧张的结果。目的：本研究探讨在2019年COVID-19大流行之前和2020-2022年期间（这是大多数美国医院增加资金的时期），较高的医院资源水平是否与较高的护士配备相关。方法：我们使用Premier Inc.的OperationsAdvisor数据库和PINC AI医疗保健数据库在78家医院的样本中探讨这个问题。我们使用(a)流动比率（资产与负债）和(b)手头现金天数来衡量资源，我们的主要结果测量是每个病人日的护士小时数（NHPPD），包括代理和加班护士小时数。我们采用了一个多变量随机效应模型，该模型具有时间与金融变量的相互作用。结果：我们发现，在新冠肺炎前，医院财力与护士配备之间没有关联。在大流行的前两个时期，尽管第一波总体人员配备有所增加，但我们观察到医院现有比率与NHPPD之间呈负相关。结论：因此，即使在大流行期间政府补贴激增，更多的资源与更多的护士人员配备并不相关。

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引用次数: 0

Patient safety ratings of hospitals by registered nurses, managers, and executives: A retrospective analysis of patient safety culture data 注册护士、管理人员和行政人员对医院的患者安全评级：患者安全文化数据的回顾性分析

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-11-01 DOI: 10.1016/j.outlook.2025.102587

DeAnna Jan Emory PhD, RN, CNE, Thomas A. Kippenbrock EdD, RN, FAAN

Background

Patient safety is a foundational component of healthcare quality, shaped by organizational culture and frontline engagement. A strong patient safety culture (PSC) promotes transparency, teamwork, and accountability to reduce harm and improve outcomes.

Purpose

This study examined differences in PSC perceptions among registered nurses (RNs), managers, and executives in U.S. hospitals to identify gaps that may impact safety initiatives.

Methods

A retrospective analysis was conducted using data from the AHRQ Patient Safety Culture Survey 2.0, collected between 2020 and 2022. The final analysis included 77,981 responses.

Discussion

Statistically significant differences (p < .001) were found across roles. RNs reported less favorable perceptions of PSC, particularly regarding staffing adequacy, psychological safety, and leadership responsiveness. Effect sizes were largest among RNs and executives.

Conclusion

These findings highlight a disconnect between frontline experiences and leadership perceptions. Addressing these gaps through inclusive safety planning and cross-level collaboration is essential to strengthening PSC systemwide.

患者安全是医疗保健质量的基本组成部分，受组织文化和一线参与的影响。强大的患者安全文化（PSC）促进透明度、团队合作和问责制，以减少伤害和改善结果。目的：本研究考察了美国医院注册护士（RNs）、管理人员和高管在PSC认知上的差异，以确定可能影响安全举措的差距。方法回顾性分析AHRQ患者安全文化调查2.0的数据，该调查收集于2020年至2022年。最终的分析包括77,981份回复。不同角色间的差异有统计学意义（p < .001）。注册护士报告对PSC的看法不太好，特别是在人员配备充足性、心理安全和领导反应性方面。注册护士和高管的效应值最大。结论：这些发现突出了一线经验与领导认知之间的脱节。通过包容性安全规划和跨级别合作来解决这些差距，对于加强全系统的PSC至关重要。

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引用次数: 0