Abstract：
BACKGROUND: About 3.5 million trauma patients are hospitalized every year, but 35%-40% require further care after discharge. Nurses\' ability to affect discharge disposition by minimizing the occurrence of nurse-sensitive indicators (catheter-associated urinary tract infection [CAUTI], central line-associated bloodstream infection [CLABSI], and hospital-acquired pressure injury [HAPI]) is unknown. These indicators may serve as surrogate measures of quality nursing care.
OBJECTIVE: The purpose of this study was to determine whether nursing care, as represented by three nurse-sensitive indicators (CAUTI, CLABSI, and HAPI), predicts discharge disposition in trauma patients.
METHODS: This study was a secondary analysis of the 2021 National Trauma Data Bank. We performed logistic regression analyses to determine the predictive effects of CAUTI, CLABSI, and HAPI on discharge disposition, controlling for participant characteristics.
RESULTS: A total of n = 29,642 patients were included, of which n = 21,469 (72%) were male, n = 16,404 (64%) were White, with a mean (SD) age of 44 (14.5) and mean (SD) Injury Severity Score of 23.2 (12.5). We created four models to test nurse-sensitive indicators, both individually and compositely, as predictors. While CAUTI and HAPI increased the odds of discharge to further care by 1.4-1.5 and 2.1 times, respectively, CLABSI was not a statistically significant predictor.
CONCLUSIONS: Both CAUTI and HAPI are statistically significant predictors of discharge to further care for patients after traumatic injury. High-quality nursing care to prevent iatrogenic complications can improve trauma patients\' long-term outcomes.
OBJECTIVE: The purpose of this study was to determine whether nursing care, as represented by three nurse-sensitive indicators (CAUTI, CLABSI, and HAPI), predicts discharge disposition in trauma patients.
METHODS: This study was a secondary analysis of the 2021 National Trauma Data Bank. We performed logistic regression analyses to determine the predictive effects of CAUTI, CLABSI, and HAPI on discharge disposition, controlling for participant characteristics.
RESULTS: A total of n = 29,642 patients were included, of which n = 21,469 (72%) were male, n = 16,404 (64%) were White, with a mean (SD) age of 44 (14.5) and mean (SD) Injury Severity Score of 23.2 (12.5). We created four models to test nurse-sensitive indicators, both individually and compositely, as predictors. While CAUTI and HAPI increased the odds of discharge to further care by 1.4-1.5 and 2.1 times, respectively, CLABSI was not a statistically significant predictor.
CONCLUSIONS: Both CAUTI and HAPI are statistically significant predictors of discharge to further care for patients after traumatic injury. High-quality nursing care to prevent iatrogenic complications can improve trauma patients\' long-term outcomes.
摘要：
背景：每年约有350万创伤患者住院，但35％-40％需要在出院后进一步护理。护士通过最小化护士敏感指标的发生来影响出院处置的能力（导管相关尿路感染[CAUTI]，中线相关血流感染[CLABSI]，和医院获得性压力损伤[HAPI])未知。这些指标可以作为优质护理的替代措施。
目的：本研究的目的是确定护理，由三个护士敏感指标(CAUTI，CLABSI,和HAPI），预测创伤患者的出院处置。
方法：本研究是对2021年国家创伤数据库的二次分析。我们进行了逻辑回归分析，以确定CAUTI的预测效果，CLABSI,和排放处置HAPI，控制参与者的特征。
结果：共纳入29,642例患者，其中n=21,469（72％）为男性，n=16,404（64%）为白人，平均（SD）年龄为44（14.5），平均（SD）损伤严重程度评分为23.2（12.5）。我们创建了四个模型来测试护士敏感指标，无论是单独还是复合，作为预测因子。虽然CAUTI和HAPI将出院接受进一步护理的几率增加了1.4-1.5和2.1倍，分别,CLABSI不是统计学上显著的预测因子。
结论：CAUTI和HAPI都是创伤后患者出院进一步护理的统计学显著预测因子。优质护理预防医源性并发症可改善创伤患者的远期预后。
目的：本研究的目的是确定护理，由三个护士敏感指标(CAUTI，CLABSI,和HAPI），预测创伤患者的出院处置。
方法：本研究是对2021年国家创伤数据库的二次分析。我们进行了逻辑回归分析，以确定CAUTI的预测效果，CLABSI,和排放处置HAPI，控制参与者的特征。
结果：共纳入29,642例患者，其中n=21,469（72％）为男性，n=16,404（64%）为白人，平均（SD）年龄为44（14.5），平均（SD）损伤严重程度评分为23.2（12.5）。我们创建了四个模型来测试护士敏感指标，无论是单独还是复合，作为预测因子。虽然CAUTI和HAPI将出院接受进一步护理的几率增加了1.4-1.5和2.1倍，分别,CLABSI不是统计学上显著的预测因子。
结论：CAUTI和HAPI都是创伤后患者出院进一步护理的统计学显著预测因子。优质护理预防医源性并发症可改善创伤患者的远期预后。
