RESUMO
PURPOSE: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity in many countries, and it has high rate of hospital readmissions due to recurrent exacerbations of the disease. Many previous studies have suggested further examination of the factors that contribute to hospital readmissions of COPD patients. However, evidence on the effects of nurse staffing by registered nurses (RNs) on the readmission of COPD patients is lacking in Korea. The aim of our study was to evaluate the effects of nurse staffing on hospital readmissions of COPD patients. METHODS: We used National Health Insurance claim data from 2002 to 2012. A total of 1,070 hospitals and 339,379 hospitalization cases were included in the analysis. We divided the number of RNs per 100 beds and the proportion of RNs on staff to one of three groups (Q1: low; Q2: moderate; Q3: high). A generalized estimating equation model was used to evaluate the associations between readmission and nurse staffing. RESULTS: A higher number of RNs was associated with lower readmission rates of 8.9% (Q2) and 7.9% (Q3) respectively. A similar effect was observed as the proportion of RNs among the total nursing staff gradually increased, resulting in lower readmission rates of 7.7% (Q2) and 8.3% (Q3). CONCLUSIONS: Our results suggest notable positive effects of nurse staffing by RNs on patient outcomes. In addition, the magnitude of impact differed between different sizes of hospitals. Thus, human resource planning to solve staffing shortages should carefully consider the qualitative aspects of the nursing staff composition.
Assuntos
Idoso , Feminino , Humanos , Masculino , Tamanho das Instituições de Saúde/estatística & dados numéricos , Hospitais Gerais/estatística & dados numéricos , Enfermeiras e Enfermeiros/provisão & distribuição , Recursos Humanos de Enfermagem Hospitalar/provisão & distribuição , Avaliação de Resultados da Assistência ao Paciente , Readmissão do Paciente/estatística & dados numéricos , Admissão e Escalonamento de Pessoal , Doença Pulmonar Obstrutiva Crônica/enfermagem , Qualidade da Assistência à Saúde , Recidiva , República da Coreia , Estudos RetrospectivosRESUMO
PURPOSE: To identify the relationship between organizational culture and experience of workplace bullying among Korean nurses. METHODS: Participants were 298 hospital nurses in Busan, South Korea. We assessed nursing organizational culture and workplace bullying among nurses using structured questionnaires from July 1 through August 15, 2014. RESULTS: Most participants considered their organizational culture as hierarchy-oriented (45.5%), followed by relation-oriented (36.0%), innovation-oriented (10.4%), and task-oriented (8.1%). According to the operational bullying criteria, the prevalence of workplace bullying was 15.8%. A multivariate logistic regression analysis revealed that the odds of being a victim of bullying were 2.58 times as high among nurses in a hierarchy-oriented culture as among nurses in a relation-oriented culture [95% confidence interval (1.12, 5.94)]. CONCLUSIONS: The results suggest that the types of nursing organizational culture are related to workplace bullying in Korean nurses. Further research is needed to develop interventions that can foster relationoriented cultures to prevent workplace bullying in nurses.