Abstract:

Objective To investigate and analyze the status of ICU nursing human resources,the quality of nursing and patient outcomes in tertiary hospitals in Henan and thereby to provide reasonable suggestions to optimize ICU nursing human resources,improve the quality of nursing and patient outcomes. Methods The self-designed questionnaire was employed to investigate the status of ICU nursing human resources,the quality of nursing and patient outcomes in 20 tertiary hospitals in Henan. Results The total number of ICU beds of 20 tertiary hospitals in Henan was 1,101;the total number of registered nurses in ICU was 3,005,and the ratio of the number of beds and nurses in ICU was 1 ∶ （2.48±0.95）. Nurses aged 25~35 accounted for 54.18% of the total number of registered nurses in ICU,while junior college nurses accounted for 53.18%,and nurses with less than 5 years working length accounted for 51.41%. The ratio of the primary,secondary and senior nurses was 1 ∶ 0.11 ∶ 0.01. The ratio of the number of beds and nurses in ICU was positively correlated to the mortality rate and the incidence of pressure injury in critically ill patients, the incidence of related blood flow infection in central venous catheter and the incidence of urinary tract infection in the catheter（P<0.05）. The proportion of intermediate professional titles in registered nurses in ICU was negatively correlated to the mortality rate of critically ill patients and the incidence of ventilator associated pneumonia（P<0.05）. The proportion of junior professional titles in registered nurses in ICU was positively correlated to the mortality rate of critically ill patients（P<0.05）. The proportion of registered nurses with bachelor’s degree in ICU was negatively correlated to the mortality rate of severe patients,the rate of unexpected 48-hours return to intensive care,the incidence of ventilator associated pneumonia and the incidence of related blood flow infection in central venous catheter（P<0.05）. Conclusion The status of ICU nursing human resources in tertiary hospitals in Henan was not reasonable,and it influences the quality of nursing and patient outcomes. Hospital leadership should attach great importance to human resources in ICU,and adjust the structure of nursing staff by professional title and education background,in order to guarantee the nursing quality and medical safety.

Key words: Tertiary Hospitals, Intensive Care Units, Health Human Resources, Nursing Quality, Nursing Administration Research

摘要：

目的 对河南省三级甲等医院ICU护理人力资源配置、护理质量及患者结局进行调查分析,为优化ICU护理人力资源配置、提高护理质量、改善患者结局提供参考依据。 方法 2017年10月采用便利抽样法和自制问卷调查河南省20所三级甲等医院ICU基本情况、人力资源状况、护理质量及患者结局。 结果 河南省20所三级甲等医院ICU实际开放总床位数为1 101张,注册护士总人数为3 005名,床护比为1 ∶ （2.48±0.95）;ICU注册护士中,25~35岁占54.18%,大专学历占53.18%,工作年限<5年占51.41%,初、中、高级职称护士比例为1 ∶ 0.11 ∶ 0.01;ICU床护比与重症患者病死率、重症患者压力性损伤发生率、中心静脉导管相关血流感染发生率及留置导尿管相关泌尿系统感染发生率呈正相关（P<0.05）;ICU注册护士中级职称比例与重症患者病死率及呼吸机相关性肺炎发病率呈负相关（P<0.05）;ICU注册护士初级职称比例与重症患者病死率呈正相关（P<0.05）;ICU注册护士本科及以上学历比例与重症患者病死率、非预期48 h重返重症医学科率、呼吸机相关性肺炎发病率及中心静脉导管相关血流感染发生率呈负相关（P<0.05）。 结论 河南省三级甲等医院ICU护理人力资源配置不够合理,影响重症患者的护理质量,医院管理者要高度重视ICU的护理人力资源配置情况,调整护士的职称、学历结构,保障护理工作质量及患者安全。

关键词: 三级甲等医院, 重症监护病房, 卫生人力, 护理质量, 护理管理研究