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首页> 外文学位 >Association among neonatal mortality, weekend or nighttime admissions and staffing in a Neonatal Intensive Care Unit.
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Association among neonatal mortality, weekend or nighttime admissions and staffing in a Neonatal Intensive Care Unit.

机译：新生儿死亡率，周末或夜间入院与新生儿重症监护室的人员编制之间的关联。

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摘要

The purpose of this study was to investigate the time of admission to a Neonatal Intensive Care Unit (NICU) and its association with in-hospital mortality among a cohort of neonates at a regional perinatal center. Two different time points were considered: admissions on the weekend versus the weekday and admissions during the nighttime shift versus the day shift. The secondary purpose of the study was to investigate if registered nurse staffing affected this association between NICU admission day or admission time and in-hospital death.;Three separate databases were used which contained information on NICU admissions, hospital deliveries and nurse staffing. These databases were linked resulting in data for each individual mother-infant pair for each separate admission to the NICU. Readmissions to the NICU, NICU admissions which could not be linked with the delivery data, admissions from the Newborn Nursery and transfers from other hospitals were excluded from the study. The final study population consisted of 1,846 admissions from October 1, 2001 through December 31, 2006.;Weekend admissions were lower than weekday admissions (29.6% versus 70.4%) and nighttime admissions were lower than day admissions (43.2% versus 56.8%). Infants admitted at nighttime were more likely to be low birth weight, have lower Apgar scores and less likely to be delivered by cesarean section. Weekend admissions did not differ significantly from weekday admissions, except weekend admissions were more likely to be Black (33.6% versus 28.6%, p=.30).;After adjusting for infant's acuity and other covariates using multivariate logistic regression, the odds of dying on the weekend was not significantly different than weekday admissions (AOR=1.06, 95% CI=.653-1.721) and were not significantly different for nighttime admissions (AOR=1.14, 95% CI=.722-1.79). Nurse staffing was not a significant covariate. Covariates which were significant risk factors for death prior to discharge were non-Black race of the infant, Apgar score of less than 7 at five minutes, presence of a fetal anomaly, and use of ventilation during the stay. Infant's birth weight was a significant protective factor.
机译：这项研究的目的是调查区域重围围产儿中心新生儿重症监护病房（NICU）的入院时间及其与住院死亡率的关系。考虑了两个不同的时间点：周末入场与工作日入场，以及夜间轮班与白班轮换。该研究的第二个目的是调查注册护士的人员配置是否影响了重症监护病房（NICU）入院日或入院时间与医院内死亡之间的这种关联。使用三个独立的数据库，其中包含有关重症监护病房（NICU）入院，医院分娩和护士人员配置的信息。这些数据库被链接起来，产生了每次单独入读新生儿重症监护病房的每个母婴对的数据。重症监护病房的再入院，无法与分娩数据关联的重症监护病房的入院，新生儿保育室的入院和其他医院的转诊均不包括在本研究中。从2001年10月1日至2006年12月31日，最终研究人群包括1846名入学者；周末入学率低于平日入学率（29.6％比70.4％），夜间入学率低于白天入学率（43.2％比56.8％）。夜间入院的婴儿出生体重较轻，Apgar评分较低且剖宫产的可能性较小。周末入院率与平日入院率没有显着差异，除了周末入院率更可能是黑人（33.6％比28.6％，p = .30）。；使用多元逻辑回归对婴儿的敏锐度和其他协变量进行调整后，死亡的几率周末的入场时间与平日的入场时间（AOR = 1.06，95％CI = .653-1.721）差异不显着，夜间入场的时间段（AOR = 1.14，95％CI = .722-1.79）差异不显着。护士人员配置不是显着的协变量。作为出院前死亡的重要危险因素的协变量是婴儿的非黑人种族，五分钟的Apgar评分小于7，胎儿异常以及在住宿期间使用通气。婴儿的出生体重是重要的保护因素。

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  • 作者

    Stanley, Leisa J.;

  • 作者单位

    University of South Florida.;

  • 授予单位 University of South Florida.;
  • 学科 Health Sciences Public Health.;Health Sciences Epidemiology.
  • 学位 Ph.D.
  • 年度 2008
  • 页码 169 p.
  • 总页数 169
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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