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Abstract：
OBJECTIVE: To analyse the patient-nurse ratio and its association with health outcomes in public hospitals of the Andalusian Health Service (SAS).
METHODS: Cross-sectional ecological study carried out in adult units of 26 Andalusian public hospitals. Data on structure (beds, type of unit, nursing control), management (average stay, index of use of stays, complexity index) and nursing staff were collected. They were extracted from official sources: CMBDA, SAS/Health Council (CS) publications and specific respondents to Nursing Directorates. The patient-nurse ratio was calculated and related to 19 indicators of hospital quality, safety, and mortality. Measures of central tendency and Spearman\'s correlation coefficient were used for statistical analysis.
RESULTS: A response was obtained from 100% of the Andalusian hospitals. The average patient-nurse ratio in the three shifts was lower in hospitals with a broader portfolio of services-regional scope (11.6), followed by those with a medium portfolio-specialties (12.7) and hospitals with a basic portfolio- county (13.5). By type of unit, the medical units were 11.8 (SD=1.8) lower than the surgical ones 13.5 (SD=2.7). Significant differences were only found in medical units of regional hospitals 10.5 (SD=1.4) and district hospitals 13.03 (SD=1.46) (p=.001). In critical care, the ratio was greater than 2 patients per nurse in the three groups. When relating the ratio to health outcomes, 5 significant associations were found: pressure ulcers (p=.005), prevalence of nosocomial infections (p=.036), postoperative sepsis (p=.022), zero bacteraemia verification (p=.045) and mortality from heart failure (p=.004).
CONCLUSIONS: The results indicate a high patient-nurse ratio in adult hospitalization units and that there is a positive association between the patient-nurse ratio and worse results related to nursing care.
METHODS: Cross-sectional ecological study carried out in adult units of 26 Andalusian public hospitals. Data on structure (beds, type of unit, nursing control), management (average stay, index of use of stays, complexity index) and nursing staff were collected. They were extracted from official sources: CMBDA, SAS/Health Council (CS) publications and specific respondents to Nursing Directorates. The patient-nurse ratio was calculated and related to 19 indicators of hospital quality, safety, and mortality. Measures of central tendency and Spearman\'s correlation coefficient were used for statistical analysis.
RESULTS: A response was obtained from 100% of the Andalusian hospitals. The average patient-nurse ratio in the three shifts was lower in hospitals with a broader portfolio of services-regional scope (11.6), followed by those with a medium portfolio-specialties (12.7) and hospitals with a basic portfolio- county (13.5). By type of unit, the medical units were 11.8 (SD=1.8) lower than the surgical ones 13.5 (SD=2.7). Significant differences were only found in medical units of regional hospitals 10.5 (SD=1.4) and district hospitals 13.03 (SD=1.46) (p=.001). In critical care, the ratio was greater than 2 patients per nurse in the three groups. When relating the ratio to health outcomes, 5 significant associations were found: pressure ulcers (p=.005), prevalence of nosocomial infections (p=.036), postoperative sepsis (p=.022), zero bacteraemia verification (p=.045) and mortality from heart failure (p=.004).
CONCLUSIONS: The results indicate a high patient-nurse ratio in adult hospitalization units and that there is a positive association between the patient-nurse ratio and worse results related to nursing care.
摘要：
目的：分析安达卢西亚卫生服务（SAS）公立医院的患者-护士比率及其与健康结果的关系。
方法：在安达卢西亚26家公立医院的成人单位进行的横断面生态学研究。结构数据(床，单位类型,护理控制)，管理(平均停留时间，住宿使用指数，复杂性指数)和护理人员的收集。它们是从官方来源提取的：CMBDA，SAS/卫生委员会（CS）出版物和护理司的特定受访者。计算患者-护士比率，并与19项医院质量指标相关，安全,和死亡率。使用集中趋势和Spearman相关系数进行统计分析。
结果：100％的安达卢西亚医院获得了响应。在三个班次中，医院的平均病人-护士比率较低，服务范围更广泛（11.6），其次是那些具有中等投资组合的专业（12.7）和具有基本投资组合的医院-县（13.5）。按单位类型,医疗单位为11.8（SD=1.8），低于手术单位13.5（SD=2.7）。仅在地区医院10.5（SD=1.4）和地区医院13.03（SD=1.46）（p=.001）的医疗单位中发现了显着差异。在重症监护中，在三组中,每位护士的比例均大于2例.当将比率与健康结果联系起来时，发现5个显著关联：压疮(p=0.005)，医院感染患病率（p=.036），术后脓毒症（p=.022），零菌血症验证(p=.045)和心力衰竭死亡率(p=.004)。
结论：结果表明，成人住院单位的病人-护士比率较高，病人-护士比率与护理相关的较差结果之间存在正相关。
方法：在安达卢西亚26家公立医院的成人单位进行的横断面生态学研究。结构数据(床，单位类型,护理控制)，管理(平均停留时间，住宿使用指数，复杂性指数)和护理人员的收集。它们是从官方来源提取的：CMBDA，SAS/卫生委员会（CS）出版物和护理司的特定受访者。计算患者-护士比率，并与19项医院质量指标相关，安全,和死亡率。使用集中趋势和Spearman相关系数进行统计分析。
结果：100％的安达卢西亚医院获得了响应。在三个班次中，医院的平均病人-护士比率较低，服务范围更广泛（11.6），其次是那些具有中等投资组合的专业（12.7）和具有基本投资组合的医院-县（13.5）。按单位类型,医疗单位为11.8（SD=1.8），低于手术单位13.5（SD=2.7）。仅在地区医院10.5（SD=1.4）和地区医院13.03（SD=1.46）（p=.001）的医疗单位中发现了显着差异。在重症监护中，在三组中,每位护士的比例均大于2例.当将比率与健康结果联系起来时，发现5个显著关联：压疮(p=0.005)，医院感染患病率（p=.036），术后脓毒症（p=.022），零菌血症验证(p=.045)和心力衰竭死亡率(p=.004)。
结论：结果表明，成人住院单位的病人-护士比率较高，病人-护士比率与护理相关的较差结果之间存在正相关。
