| Summary: | 碩士 === 國立成功大學 === 護理學系 === 104 === Background
Higher nursing hours per patient day (NHPPD) is associated with better patient outcomes, such as a lower inpatient mortality rate. There is currently a shortage of nursing staff in Taiwan due to changes in the healthcare and global budget systems, and this may decrease the NHPPD and harm patient safety. The literature remained inconclusive on the relationship between NHPPD and inpatient mortality rate, and no studies have yet examined this issue in Taiwan.
Purpose
This research was to explore the relationship between NHPPD and inpatient mortality rate at nursing units in Taiwanese hospitals.
Method
This was a retrospective longitudinal study using data from “Nursing Utilization of Resources, Staffing and Environment on Outcome Study: NURSE - outcome study”, which was funded by the Taiwan Ministry of Health and Welfare from 2009 to 2010. We retrieved the NHPPD, inpatient mortality rate, aggregated patients’ and nurse staffing variables from this database. Data was analyzed using a hierarchical regression model to estimate the relationship between NHPPD and the in-hospital mortality rate after controlling the confounding variables that affected the inpatient mortality rate.
Result
Higher NHPPD was related to a lower inpatient mortality rate after controlling the confounding variables. The average NHPPD in Taiwan was 2.32 hours, and inpatient mortality rate would decrease 4.543%, 2.271%, 1.514% when the NHPPD increased by 4.64 hours, 6.96 hours and 9.28 hours. The total explained variation of the hierarchical regression model was 19.9%. In addition, there was significant relationships between inpatient mortality rate and three other variables which were regional hospital/ district hospital (β = -.155, p 〈 .01), quarter 4/ quarter 1 (β = -.133, p 〈 .01) and nurses’ work experience (β = .13, p 〈 .001).
Conclusion
NHPPD affected the risk-adjusted mortality rate among hospitalized patients in Taiwan. Nevertheless, low explained variation in the study has remained to be addressed in future work. Each confounding variable in this study is an important issue that also needs to be explored separately.
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