Association between Nurse Staffing and In‐Hospital Bone Fractures: A Retrospective Cohort Study
研究利用日本数据库分析护士与床位比与住院骨折的关系，发现高护士配备可显著降低术后骨折风险，对医院管理者和护理政策制定者有参考价值。
OBJECTIVE: To determine if sufficient nurse staffing reduced in-hospital fractures in acute care hospitals. DATA SOURCES/STUDY SETTING: The Japanese Diagnosis Procedure Combination inpatient (DPC) database from July 2010 to March 2014 linked with the Surveys for Medical Institutions. STUDY DESIGN: We conducted a retrospective cohort study to examine the association of inpatient nurse-to-occupied bed ratio (NBR) with in-hospital fractures. Multivariable logistic regression with generalized estimating equations was performed, adjusting for patient characteristics and hospital characteristics. DATA COLLECTION/EXTRACTION METHODS: We identified 770,373 patients aged 50 years or older who underwent planned major surgery for some forms of cancer or cardiovascular diseases. We used ICD-10 codes and postoperative procedure codes to identify patients with in-hospital fractures. Hospital characteristics were obtained from the "Survey of Medical Institutions and Hospital Report" and "Annual Report for Functions of Medical Institutions." PRINCIPAL FINDINGS: Overall, 662 (0.09 percent) in-hospital fractures were identified. Logistic regression analysis showed that the proportion of in-hospital fractures in the group with the highest NBR was significantly lower than that in the group with the lowest NBR (adjusted odd ratios, 0.67; 95 percent confidence interval, 0.44-0.99; p = .048). CONCLUSIONS: Sufficient nurse staffing may be important to reduce postsurgical in-hospital fractures in acute care hospitals.